Eye tracking in Paediatric Dentistry:

An Adjunct in Behavior Management

Prof(Dr) Rakesh K Gupta

Principal/ Dean
Indira Gandhi Government Dental College,
Jammu
 EYE TRACKING

Eye tracking is a technology of

tracking a person’s eye movement to
determine:

Where they are looking,

For how long, and
How the eye got there?
 Why eye tracking?

TO UNDERSTAND HUMAN
BEHAVIOR AND THINKING!

• With an Eye Tracker we know

exactly where a person is looking.
• We get clear additional insight
behaviour through their eye.
This experimental tool has been
used in various scientific fields:

• Psychology
• Neurology
• Psycholinguistics
• Marketing

Now used in Dentistry and

Paediatric Dentistry
 TYPES OF EYE TRACKERS
1. Remote Eye Trackers: Use cameras to monitor and record the
movement of the eyes from a distance.

2. Head-Mounted Eye Trackers: Mounted on a device worn by the

patient, such as glasses or a headband.

3. Desktop-Mounted Eye Trackers: Mounted on a stationary

platform, often placed on a desk or attached to dental equipment.

4. Wearable Eye Trackers: Small, lightweight eye-tracking devices

that can be worn on the body or integrated into clothing.

5. Mobile Device-Based Eye Trackers: Utilizes the built-in cameras

of smartphones or tablets to track eye movements.
•Category 1: External device
•Device: Tobii 4C
•Tobii EyeX
•Smart Eye Pro camera
•Gazepoint GP3
•Use case Most versatile, primary for
digital product testing
•Articles Annerer-Walcher et al.,
2021; Capdevila et al., 2021;
Category 3: VR
•Device: HTC Vive
•FOVE VR
•Varjo VR-2
•Use case Games, Architecture
•Articles Abdessalem et al., 2019;
Capdevila et al., 2021
•Category 2: Glasses, head-
mounted
•Device: Tobii Pro Glasses 3
•SMI Eye Tracking Glasses 2
•Pupil Labs Invisible
•Use case Physical product testing
Automotive, Medical
•Articles Boi et al., 2016; Cazzato et al.,
2020; Wegner et al., 2020
Category 4: Budget
•Device: Phone
•Webcam
•Use case SW usability testing,
gesture detection
•Articles Aviz et al., 2019;
Valliappan et al., 2020
 Eye Tracking Process

 The most popular are optical methods.

 Here, typically infrared is reflected from the

eye and sensed by a camera or some other
optically designed sensor.

 The data is then analyzed to extract eye

rotation from changes in the reflection.
 PROCESS
Illuminate Pupil Using Infrared
Light

Reflection On Cornea

Bends Light And Focuses Most Of

Light That Enters Eye

Reflection Recorded By Eye

Tracker

(Hansen & Ji, 2010)

What Does Eye Tracker Determines?
 Centre of pupil

 Eye rotation

 Gaze direction

 Areas of interest

 Pupil Size
 PUPIL SIZE
Pupil size reveal a lot about
our underlying emotional
processes
“Your pupils become larger
when you see someone you
love”
 Why use pupil dilation to study emotion processing ?

Pupil size reveal a lot about our underlying emotional

processes
“Your pupils become larger when you see someone you
love”
 Principal of Eye Tracking

Eye trackers use the centre of the pupil and

infrared/near-infrared non-collimated light to generate
corneal reflections. The vector between the pupil centre
and corneal reflections can be utilized to calculate the
point of regard on the surface or gaze directions.
 Functions of Eye Tracking

It helps observe and measure eye movements, pupil dilation, point of gaze, and
blinking to understand where subjects of study focus their visual attention,
what they engage with, and what they ignore.
Our pupils tend to get larger(i.e. dilate) when we are engaged in a cognitively
demanding task
Thus, pupils don’t only change size depending on the light
 VARIOUS APPLICATIONS IN DENTISTRY

• Behavioral Assessment:Eye trackers can be used to assess the visual attention and gaze patterns of
pediatric patients during dental procedures.Helps in understanding the child's reactions, identifying anxiety triggers, and
gauging overall comfort.

Dental fear and anxiety exist in children prior even to their first dental visit either due to a huge variation in age,
competence, maturity, personality, parenting styles, culture, or parental modelling.

Therefore, one could suggest that all these aspects may influence the child’s ability to cope with the dental treatment; thus,
posing a great challenge to the treating dentist.

Furthermore, these non-dental factors exhibit immense potential to unravel the critical aspects that lead to the development
of both dental fear and anxiety and dental behaviour management problems in children and adolescents’
 VARIOUS APPLICATIONS IN DENTISTRY

• Communication Studies:Allows for the analysis of communication between the dentist and the child by
tracking eye movements.Helps in refining communication strategies to ease anxiety and enhance cooperation.
Supplementary communication between dentist and patients
Certain patients with their mouths propped open cannot talk, and therefore, a
supplementary mechanism is needed to convey their discomfort and their needs.
Or Children not able to communicate, special children, fearful children, etc

• Treatment Planning:Supports dentists in understanding how children visually process dental instruments, equipment,
or other stimuli during treatment.Aids in optimizing the layout of the dental office for a child-friendly environment.
• Research and Training:Provides valuable data for research on pediatric dental phobia and anxiety.Can be used in the
training of dentists to improve their interactions with pediatric patients.
 VARIOUS APPLICATIONS IN DENTISTRY
• During dental treatment, verbal communication between patients and dentist is largely hindered, often happens when a
patient has a "rubber dam" on for isolation, in cases of special children or fearful anxious children.
• It is proposed that using eye tracking as a supplementary mechanism for communication could prove beneficial.
• Such patients can use eye tracking to convey their discomfort and their needs.
• A menu of what patients may want to communicate can be displayed on the eye-tracking device monitor for patient
selection.
• For example, a patient can select from the following choices:
I am ok, please continue
Please stop
Suction please, need to spit
I need to sit up
I am in pain, need more anesthetic
I need a mouth prop
Restroom break
PAIN DETECTION
Objective measures
such as eye
movements and
facial patterns can
potentially be useful
in enabling the
Another useful application of eye tracking is detection of pain reflex.
dentist to assess the The dentist can potentially utilize eye and facial pattern tracking to detect painful response
effectiveness of patterns on pediatric patients and certain geriatric patients who are not able to clearly

anesthetic express what they feel.

Perception of
people or Eye-tracking results indicated that crowded teeth drew more
visual attention and were more noticeable than aligned ones.
patients Another eye-tracking research showed that when dental
attractiveness decreased, visual attention on the mouth increased,
towards toward a level approaching that of the eyes.

treatment
 The use of Eye-Tracking Technology in Pediatric Orofacial Clefts
A negative social perception is often associated with patients with CL+/P due to their perceived unattractive facial
appearance.

Furthermore, the facial perceptions of different population groups are essential because of their indirect effects on the
emotional and social well-being of children with orofacial clefts

This might indicate the usefulness of eye-tracking technology as a metric for assessing the success of cleft
repairs based on the perceptions of different populations.

Similarly for all the treatments we could use the perception of general population and modify the
treatment needs or methods in that way achieving the Positivity and Acceptance.
 VARIOUS APPLICATIONS IN DENTISTRY

• Treatment Planning:Supports dentists in understanding how children visually process

dental instruments, equipment, or other stimuli during treatment.Aids in optimizing the
layout of the dental office for a child-friendly environment.

• Research and Training:Provides valuable data for research on pediatric dental phobia
and anxiety.Can be used in the training of dentists to improve their interactions with
pediatric patients.
 Advantages of using Eye Trackers
➢ Improved Communication:

Understanding the child's visual focus allows for better communication.

➢ Customized Approach:

Enables dentists to personalize treatment approaches based on individual patient responses and visual
preferences.

➢ Efficiency and Precision:

Helps dentists optimize their procedures by understanding where a child is looking, allowing for more
efficient and precise treatment.

➢ Research Insights:

Supports research efforts to develop evidence-based practices for pediatric dentistry, leading to improved
strategies for managing anxiety and fear.
 Disadvantages of using Eye Trackers

➢ Cost:
Eye-tracking technology can be expensive to purchase, install, and maintain.

➢ Limited Generalization:
It may not always generalize well across all pediatric patients, as individual responses can vary widely.

➢ Calibration Challenges:
Accurate calibration for pediatric patients can be challenging due to their limited attention span.

➢ Intrusiveness:
Some children may find the eye-tracking equipment and setup intrusive or uncomfortable, potentially increasing
anxiety levels during dental procedures.

➢ Ethical Considerations:
Obtaining informed consent and ensuring the confidentiality of data are crucial ethical considerations leading
to Privacy concerns.

➢ Patient Cooperation:
Some children may resist wearing eye-tracking devices.
 Future of Eye Trackers
• Real-time Feedback for Dentists:
Eye trackers may provide dentists with real-time feedback on a child's visual attention and anxiety
levels.

• Integration with Virtual Reality (VR) and Augmented Reality (AR):

Combining eye-tracking technology with VR or AR can create immersive and interactive
environments for pediatric patients during dental visits.

• Artificial Intelligence (AI) Applications:

AI algorithms may be developed to analyze eye-tracking data more efficiently, providing dentists with
actionable insights.

• Miniaturization and Non-intrusive Designs:

Advancements in technology may lead to smaller and more non-intrusive eye-tracking devices that are
less cumbersome for pediatric patients.
 To conclude,
In conclusion, the use of eye trackers in pediatric dentistry holds promise for enhancing patient care,

improving treatment outcomes, and advancing research in the field. Integrating this technology responsibly

and ethically can contribute to a more child-friendly dental environment, ultimately promoting positive oral

health experiences for young patients.

 EYES HOLD THE STORY

THANKYOU

AS IT IS SAID
EYES ARE WINDOWS TO SOUL
EYE TRACKING IS A WINDOW TO HUMAN MIND