Evaluating Internet-Based AI Chatbots as Unregulated Digital Health Resources in Dental Emergency Management: Comparative Multilingual Study

Evaluating Internet-Based AI Chatbots as Unregulated Digital Health Resources in Dental Emergency Management: Comparative Multilingual Study. Bashah A(1), Huixin Q(1), Zaawari H(2), Al-Waqeerah A(3), Ghaleb E(4), Salem A(5), Wahan N(5), Chen G(1). BACKGROUND: Publicly accessible, internet-based AI chatbots have emerged as unregulated digital health resources that clinicians and patients consult in real time, including during acute medical emergencies. In dental practice-where life-threatening events such as anaphylaxis, cardiac arrest, and severe hypoglycemia can unfold within seconds-the unsupervised use of these tools as point-of-care decision aids poses uncharacterized patient safety risks. Despite widespread deployment, no study has systematically evaluated the accuracy, temporal consistency, or multilingual reliability of contemporary large language model (LLM)-based chatbots specifically for dental medical emergency management. OBJECTIVE: This study aimed to evaluate the accuracy, temporal stability, and multilingual performance of five contemporary LLM-based chatbots when queried on the management of medical emergencies in dental practice. METHODS: A comparative study was conducted to assess five AI chatbots: ChatGPT-5.2 (OpenAI), Gemini 3.1 (Google), DeepSeek-R1 (DeepSeek AI), Grok 4.20 (xAI), and Kimi K2.5 (Moonshot AI). A total of 130 questions covering dental medical emergency management were developed and categorized into four formats: multiple-choice questions (MCQs), yes-or-no questions, open-ended WH questions, and clinical scenario questions. Each question was presented using two prompting strategies (basic and advanced) across three languages (English, Arabic, and Chinese). Data collection was performed over seven consecutive days, generating 27,300 chatbot responses. Responses were evaluated by language-specific expert reviewers and classified as correct or incorrect based on established clinical references. Statistical analysis was performed using…