# The sample case: FR-0005

> 0 of 12 answers from three frontier models passed. A practicing dentist wrote this question. Three frontier models each answered it four times. None of the twelve answers passed.

General dentistry · Treatment plan · Reviewed 28 October 2026

## The question

> I have a patient. He is 75 years old. He has Parkinson's disease. He is living in a government run long term care home. He has limited income. He has generalized root and recurrent caries. What are the best options for managing his long term dental care.

Asked exactly as the dentist wrote it. The patient is a composite with no identifying details.

## The scores

| Model | Answer 1 | Answer 2 | Answer 3 | Answer 4 | Mean |
|---|---|---|---|---|---|
| Claude Opus 5.5 | 36% | 29% | 26% | 44% | 34% |
| GPT-6 Astra | 18% | 28% | 15% | 4% | 16% |
| Gemini 4 Argon | 26% | 33% | 35% | 36% | 33% |

Scores ranged from 4% to 44%. The pass line is 60%. Each answer was graded by the two other models against the dentist's rubric.

## The rubric

No model chose the dentist's treatment plan, and no model gave the reasoning behind it.

Most of the points are for getting the plan right. General advice earns some, but not enough to pass.

### Never earned by any attempt

- 10 points. Recommends implant-supported removable dentures (implant-retained dentures or overdentures) as the preferred solution.
- 10 points. States that a conventional lower complete denture is hard to retain, so a lower denture needs implant support.
- 7 points. Weighs the patient's likely remaining lifespan against how long each treatment takes and how long it lasts.
- 7 points. States that extraction of all teeth with fixed implant-supported bridges would be ideal, but is not suitable for this patient.
- 5 points. Recommends that care staff maintain the implants and dentures with ongoing daily oral hygiene.
- 4 points. Explains that fixed implant bridges avoid a removable denture and its acrylic.

### Earned by some attempts

- 6 points. Takes the patient's ability to pay for treatment into account. Earned: 96% of credit across the 12 answers.
- 10 points. States that restoring all carious teeth is not realistic for this patient. Earned: 75% of credit across the 12 answers.
- 9 points. States that Parkinson's disease reduces manual dexterity, so the patient cannot reliably clean his own teeth or dentures. Earned: 67% of credit across the 12 answers.
- 8 points. States that a long-term care home resident relies on staff for daily oral hygiene, and that this care is often limited. Earned: 42% of credit across the 12 answers.
- 8 points. States that with Parkinson's, involuntary movements may dislodge the denture. Earned: 25% of credit across the 12 answers.
- 7 points. Rules out the fixed implant options because of the patient's finances. Earned: 12% of credit across the 12 answers.

### Penalties

- -10 points. Recommends a lower complete denture without implants. Never triggered.
- -5 points. Lists more than 3 treatment options without committing to one. Triggered in 8 of 12 answers.
- -5 points. Fails to advise the patient about ongoing maintenance. Never triggered.

Total: 91 points. The dentist's plan and its reasoning: 43 points.

## The dentist against the models

The dentist planned for this patient. The models gave the general answer. Both agreed that restoring every tooth isn't realistic. They split on what to do instead.

### The dentist's plan

- Restoring all the carious teeth is not realistic for this patient.
- Extraction of all teeth with fixed implant-supported bridges would be ideal, but it is ruled out because of the patient's finances.
- A conventional lower complete denture is hard to retain, so any lower denture needs implant support.
- Weigh his likely remaining lifespan against how long each treatment takes and how long it lasts.
- Care home staff maintain the implants and dentures with ongoing daily oral hygiene.

Preferred solution: implant-supported removable dentures.

### What the models did

- Silver diamine fluoride and high-fluoride toothpaste in all 12.
- Glass-ionomer restorations in 9.
- Several ruled implants out on cost and disease progression.
- No answer weighed remaining lifespan against treatment time and longevity.
- No answer said a conventional lower denture would be hard to retain.

Preferred solution: prevention first. No implants.

## About this case

This case was written as a sample and is not for sale. We publish it so you can check our work line by line. The cases we sell are never published.

More: https://frontierdental.io/index.md