Diagnostic Capabilities of Large Language Models in Paediatric Dentistry

Although many studies have examined large language models (LLMs) for dental diagnosis, most focus on a single topic, and few have investigated their broader usefulness for the variety of patients. Twenty-five cases meeting the eligibility criteria were extracted from paediatric dentistry questions in the National Examination. Age, sex, and chief complaint were collected and presented to Copilot and Gemini along with intraoral photographs and radiographic examinations, instructing them to identify abnormal areas and provide a diagnosis. Both LLMs showed >70% accuracy in identifying pathological locations and approximately 60% accuracy in making diagnoses. However, accuracy decreased markedly when the chief complaint was omitted. In incorrect location responses, models often selected adjacent teeth when a chief complaint was present, whereas entirely different sites were more common when no chief complaint was provided. Although diagnostic accuracy for apical periodontitis was high under all four conditions, accuracy dropped substantially for paediatric-specific topics such as abnormalities in tooth number and abnormal eruption when the chief complaint was absent. These findings suggest the potential for using LLMs in paediatric dentistry; however, obtaining an accurate chief complaint is essential. Moreover, LLMs still show limitations in areas unique to paediatric dentistry, highlighting the need for further development.