Evaluating the evidence-based potential of six large language models in paediatric dentistry: a comparative study on generative artificial intelligence

Abstract Purpose The use of large language models (LLMs) in generative artificial intelligence (AI) is rapidly increasing in dentistry. However, their reliability is yet to be fully founded. This study aims to evaluate the diagnostic accuracy, clinical applicability, and patient education potential of LLMs in paediatric dentistry, by evaluating the responses of six LLMs: Google AI’s Gemini and Gemini Advanced, OpenAI’s ChatGPT-3.5, -4o and -4, and Microsoft’s Copilot. Methods Ten open-type clinical questions, relevant to paediatric dentistry were posed to the LLMs. The responses were graded by two independent evaluators from 0 to 10 using a detailed rubric. After 4 weeks, answers were reevaluated to assess intra-evaluator reliability. Statistical comparisons used Friedman’s and Wilcoxon’s and Kruskal–Wallis tests to assess the model that provided the most comprehensive, accurate, explicit and relevant answers. Results Variations of results were noted. Chat GPT 4 answers were scored as the best (average score 8.08), followed by the answers of Gemini Advanced (8.06), ChatGPT 4o (8.01), ChatGPT 3.5 (7.61), Gemini (7,32) and Copilot (5.41). Statistical analysis revealed that Chat GPT 4 outperformed all other LLMs, and the difference was statistically significant. Despite variations and different responses to the same queries, remarkable similarities were observed. Except for Copilot, all chatbots managed to achieve a score level above 6.5 on all queries. Conclusion This study demonstrates the potential use of language models (LLMs) in supporting evidence-based paediatric dentistry. Nevertheless, they cannot be regarded as completely trustworthy. Dental professionals should critically use AI models as supportive tools and not as a substitute of overall scientific knowledge and critical thinking.