Eye-tracking in dentistry: What do children notice in the dentist?

Objectives: To determine, using eye-tracking technology, what children notice the most when they look at the dentist. Methods: A total of 41 children viewed 10 images of dentists of different genders and ethnicities, and wearing different attires, on a computer screen. Due to calibration issues with the eye tracking equipment, data from one child was excluded thus resulting in a final sample of 40 children (21 females; 19 males). Participants were aged 4-12 years. A Tobii X2-60 eye-tracking camera was used, which follows the location of participants' gaze as they look at images on a screen. Areas of interest (AOI's) were pre-defined on each image (e.g. eyes, mouth, shirt). Other images were displayed between dentist images with no consecutive dentist images displayed. Number of participants to fixate and mean length of fixation for each AOI were measured. Results: Visual assessment illustrated that the dentist's face had the highest concentration of fixations, followed by attire. The circum-oral area has significantly more fixations than the eyes. The number of fixations and the mean length of fixation were both longer for the face than for the attire, and for the circum-oral area compared to the eyes. Distracters such as pens and ties exhibited more and longer fixations compared to images without distractors. Conclusions: Children fixated most on the dentist's face particularly the circum-oral area, followed by attire. Distracters were able to draw the children's gaze. Importantly, eye-tracking was an effective tool in assessing where children look on dentists' images. Clinical significance: This research will provide an understanding of where children focus when they look at a dentist. This has not previously been known and will allow dentists to modify how they present themselves and interact with child patients.