Exploring Mind Behind the Mouth in Dentistry:A Qualitative Perspective

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Exploring Mind Behind the Mouth in Dentistry: A Qualitative Perspective

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Good mental health can be theorized as an atmosphere of psychological wellness that incentivizes people to manage and cope with routine life stresses while maintaining optimal functioning (Fusar-Poli et al., 2020). The uncertainties and concerns during the Coronavirus pandemic incentivized heightened mental health issues globally. Despite the COVID-19 control guidelines requiring all people to wear masks, the nature of dental health care workers’ (DHCWs) care services requires clients to remove their face masks when interacting with the health care system. This work-related landscape posed a significant exposure and infection risk. Dentistry entails complex procedures that require repetitive movements, fine tactile movements, and firm grasp, with extended static postures to access poorly illuminated areas (Chenna et al., 2023). As a result, dental professionals typically struggle with musculoskeletal disorders, with carpal tunnel syndrome (CTS) being a common health problem. CTS negatively affects the dentists’ quality of life, limits their daily living, reduces productivity, causes poor sleep patterns, and might prompt one to leave the profession (Chenna et al., 2023). In addition, working full-time in dentistry is associated with burnout and heightened emotional exhaustion. As a result of working full-time, 30.9% of dental hygienists in California reported struggling with burnout (Bercasio et al., 2020). These deteriorated health outcomes could contribute to symptoms related to anxiety and depression.

DHCWs struggled working in a volatile practice context with changing infection control and prevention guidelines for COVID-19, and this significantly undermined their mental health. Research showed that the rate of anxiety symptoms reached its highest levels in November 2020, affecting 28% of dental hygienists and 17% of dentists, before dropping to 12% for both groups by May 2021 (Eldridge et al., 2022). The same study also found that the rate of depression symptoms peaked in December 2020, with 17% of dental hygienists and 10% of dentists reporting such clinical manifestations, and decreased to 8% by May 2021 (Eldridge et al., 2022). Mental health issues are well-established among dentists and dental hygienists, not only in the U.S. but also across the world. A survey on mental health among dentists outside of the U.S. indicated that at least 80% of these professionals struggled with anxiety, particularly attributed to worries about contracting the Coronavirus as well as concerns about the future of the profession (Eldridge et al., 2022). In the United Kingdom, at least 71% of dentists reported struggling with anxiety-associated clinical manifestations, with 60% reporting depression-associated manifestations (Eldridge et al., 2022). These dental professionals could not spend time with family members due to the risk of spreading the disease. The problem is depression and anxiety symptoms among dentists and dental hygienists working in private practice settings in California. The purpose of this qualitative phenomenological study is to explore the lived experiences of dentists and dental hygienists who work in private practice settings in California regarding mental health issues related to depression and anxiety.

The dissertation will be guided by the following research questions:

Research Question 1: What are the lived experiences among dentists and dental hygienists working in California?

Research Question 2: How do dentists and dental hygienists describe professional stressors contributing to experiences of anxiety in their routine practice?

The proposed research site is specified, that is, private healthcare facilities. The present paper discusses the dissertation’s (a) research methodology, design, and rationale, (b) role of the researcher, and (c) research procedures, which include population and sample selection as well as recruitment processes.

Research Methodology, Design, and Rationale

Methodology

The dissertation will use a qualitative research methodology. Qualitative research can be defined as a methodology that allows the researcher to explore and understand the meanings that groups or individuals infer about a human or social phenomenon or problem (Creswell & Creswell, 2020). As noted in the introduction, the present dissertation seeks to understand the lived experiences among DHCWs working in California, including the professional and personal variables that they attribute to their anxiety-associated symptoms within their day-to-day practice. The qualitative research methodology is justified because it demands that clear procedures and questions guide the study, data be collected within the participants' practice setting, data analysis be inductively built from particular to general themes, and the researcher make interpretations that give meaning to the data (Creswell & Creswell, 2020). All these demands are achievable, considering that the present dissertation seeks to honor an inductive approach, emphasize individual meaning, and acknowledge the value of recognizing the complexity of the phenomenon or situation.

Additionally, the qualitative research methodology is justified because it will allow for in-depth interviewing based on flexible and informal data collection approaches. The present study uses a qualitative methodology, which is appropriate because it allows for unstructured interviewing where the wording of the questions mirrors a casual conversation and entails a wide range of friendly exchanges between the interviewee and the interviewer, with flexibility in issues to be explored (Symbaluk & Hall, 2024). In addition, a qualitative methodology resonates with the need to understand the lived experiences of DHCWs concerning mental health issues in practice contexts. Qualitative interviews are more appropriate for the present dissertation because they entail listening, understanding, and asking questions. The methodology shares attributes similar to everyday conversations, incorporating a fundamental social component (Symbaluk & Hall, 2024). The interviewer engages in a “responsive” approach based on the design flexibility, which allows them to change the questions as they learn about the participants' lived experiences.

Design

Phenomenology is the selected research design for the present dissertation. Creswell and Creswell (2020) defined phenomenological research as an inquiry strategy whose purpose is to empower the researcher to identify the essence of human or group experiences concerning a phenomenon as delineated by the participants. The design is typically applied in social and educational research as a theoretical tool that helps the researcher to engage in malleable activities that delineate and contribute to the understanding of a complex phenomenon like diverse aspects of human social experience (Alhazmi & Kaufmann, 2022) The present dissertation’s research questions seeks to capture dentists and dental hygienists’ lived experiences within their practice environment and thus a phenomenology design resonates with such needs. The phenomenology design is advantageous because it helps understand participants’ lived experiences (Flick, 2022). In this vein, the design is delineated as a method, procedure, as well as a philosophy that entails studying a small number of participants through an increasingly prolonged and extensive engagement to derive relationships and patterns of meaning (Creswell & Creswell, 2020). It is anticipated that the researcher will set aside their personal experiences and immerse themselves in understanding the lived experiences of their research participants, which will help reduce the potential for researcher bias.

Type of Design

The dissertation employs a descriptive phenomenology, a type of design that focuses on revealing the “essential structure” or “essence” of the phenomenon being investigated – that is, those attributes that make it what it is as opposed to something else. Researchers who are new to the application of descriptive phenomenology in social sciences or psychology should follow Colaizzi’s 1978 steps to achieve a rigorous analysis. Colaizzi’s descriptive phenomenological design entails seven steps: familiarization, establishing important statements, formulating meanings, clustering themes, designing an exhaustive description, producing the fundamental structure, and selecting fundamental structure verification (Beck, 2021). By following these steps, the researcher will make the dissertation truly descriptive and able to capture the participants’ lived experiences as required in a phenomenological qualitative study (Flick, 2022).

In order to ensure rigor in each of Colaizzi’s stages, the researcher will ensure each step does not deviate from the data being collected. Participants should validate each step’s description of the phenomenon being investigated to ensure it reflects their first-person accounts. In step seven, for instance, Colaizzi’s approach emphasizes the need to validate the findings based on the “member checking” approach, whereby the results are returned to the participants for an authentic discussion.

Role of the Researcher

I will be expected to play different roles in the present phenomenology. I will use unstructured interviews as a more practical approach to understand the lived experiences of participants. In this case, an unstructured interview is preferred because it is predominantly used in qualitative studies to allow for an in-depth interviewing process and participant interaction. In this case, I will be tasked with developing questions based on respondents' answers. I will also need to be careful when documenting and interpreting the respondent’s perspectives to avoid undermining the study’s validity and reliability. I will also be tasked with selecting the sample size and the sampling method. It is also necessary to make considerations tailored to establish rapport with the interviewees.

Although I am not connected to participants personally or professionally, I will take into account fundamental ethical considerations in the initial planning phase of the dissertation. Given that it will be a social research project, there is minimal risk of harm to participants. To avoid ethical issues related to in-depth interviews for both the researcher and the research ethics review board, it is necessary to anticipate in advance the types of risks that participants will experience, particularly because the questions are likely to evoke emotions (Symbaluk & Hall, 2024). I will need to be qualified enough to conduct an in-depth interview. I have previous research experience, and I have familiarized myself with qualitative interviewing approaches through research training. I will protect the privacy of the interviewees by attaching an alias name or a pseudonym to the interviewee’s responses. Identifying details will also be left out or removed from the published findings. Lastly, I will use password-protected software on my computers to ensure participants' responses are not accessed or stolen by someone else (Symbaluk & Hall, 2024).

The flexibility of unstructured interviews supports the validity of the results and conclusions reached. I will be able to seek clarifications of questions and utilize prompts anchored directly to the interviewee’s responses. This augments validity by ensuring that the obtained data reflect the interviewee’s construction of reality concerning the phenomenon. However, research shows that the qualitative researcher should interpret and reconstruct the transcribed data in a way that reflects the respondent’s authentic perspective (Symbaluk & Hall, 2024). The obtained data, despite not attaining reliability thresholds in a “quantitative” sense, will result in more dependable results because the researcher will be careful to document the research process, including the findings’ interpretations, and justification of the reached conclusions.

I will set aside personal assumptions using Colaizzi’s bracketing approach. Bracketing entails deliberate efforts by the researcher to set aside personal beliefs about the phenomenon being investigated or their previous knowledge about the subject matter (Beck, 2021). Bracketing will be employed using reflexivity to help establish possible influences when doing the research. Reflexivity entails a genuine examination of the researcher’s interests and values that might influence the scholarly inquiry (Beck, 2021).