Pocket-Dentist: Efficient Multimodal QA for On-Device Dental Image Understanding

Evaluations of dental vision-language models remain fragmented across datasets, task definitions and metrics, and often ignore their computational cost. This limits their widespread deployment for dental screening outside specialist centres, where timely inference, limited hardware, and local handling of patient images are vital for practical, privacy-preserving clinical prescreening. Here we present Pocket-Dentist, an efficiency-aware benchmark for dental multimodal question answering that brings together three datasets spanning 1,159 patients, five task types and seven metrics. Across typical 14 VLMs, our results reveal an interesting observation: compact VLMs, such as 2B-parameter models, outperform larger VLMs in accuracy while requiring substantially lower computational costs in dental image understanding. Deployed locally on an iPhone 17 Pro, our finetuned compact VLM Pocket-Dentist-2B processed each sample in 4.31 s, reducing latency by 4.9-fold and memory use by 2.3-fold compared with a 7B baseline.