Does a dental office need an on-site server or can it run in the cloud?

Key facts

How do I know which camp my software is in?

Ask where the patient database lives. If it's on a computer in your office, you need a server, or at least a dedicated computer acting as one. If it lives in the vendor's data center and you reach it through a browser, you don't.

• Local database: Dentrix, Eaglesoft and self-hosted Open Dental keep the database on a machine in the office (FloorStack).
• Cloud: Curve Dental and Dentrix Ascend run in a browser (Curve; Dentrix Ascend). Open Dental also sells a hosted version, Open Dental Cloud (Open Dental).

What do the 2026 server specs actually say?

They disagree more than you'd expect, so size to your vendor's document, not a generic "dental server."

Dentrix. Henry Schein One's April 2026 requirements list Windows Server 2016, 2019, 2022 and 2025, 64-bit, with 16 GB RAM (more for over 10 workstations), four or more cores at 2.4 GHz, 60 GB free on SSD or NVMe and a 1 Gbps network. Server Essentials and Small Business editions aren't supported because of port conflicts with backups. The document also says Dentrix has been tested on properly configured Hyper-V and VMware virtual machines (Dentrix System Requirements 2026).

Eaglesoft. Patterson's hardware document, for offices with nine or fewer workstations, calls for an Intel i5 (8th gen or later), 16 GB RAM, a 1 TB 7200 RPM drive in RAID 1 and gigabit Ethernet. It recommends a dedicated Eaglesoft server for six or more workstations (Patterson). Patterson supports Windows Server 2019, 2022 and 2025 to host the Eaglesoft server, with 2025 requiring Eaglesoft 24.20.03 or newer (Patterson Answer 39877).

Open Dental. For 1–10 workstations, Open Dental lists a dual-core CPU, Windows 11 Professional and 4 GB RAM for the MySQL/MariaDB server, scaling to Windows Server or Linux as workstation count rises. It notes that Windows 11 Professional allows up to 20 concurrent connections (Open Dental Hardware Requirements). It also recommends a dedicated server to protect data (Open Dental).

Two practical points. First, Henry Schein One says it stopped supporting new Dentrix installs on Windows 10 after June 30, 2026 (Dentrix 2026), so check workstation OS versions in any practice you're buying. Second, your imaging software often has its own server and storage requirements on top of the PMS.

To see this on your own floor plan, FloorStack Studio (live, free plan) builds a 3D IT plan of your office with every device placed.

To turn this into a drawing your low-voltage contractor can bid, the free network & IT plan generator (coming soon) is planned to produce drops, rack, Wi-Fi and VLAN plans from your floor plan.

If I go cloud, what still has to be in the office?

More than the brochure suggests:

• Windows PCs at the chair for imaging. Curve says Curve Capture isn't supported on terminal servers because it needs direct, local access to imaging devices, and that Schick imaging drivers need an Intel or AMD processor (Curve). Open Dental Cloud needs ODCloudClient installed on a Windows machine to bridge to imaging and card processing (Open Dental).
• Local image storage, in many setups, for speed. Large pano and CBCT files are slow to pull over the internet. Confirm with your imaging vendor.
• A much better internet connection. With no local server, the internet becomes the single point of failure, so a backup line stops being optional (FloorStack). See internet speed for a dental office.

Which is more secure?

Neither is secure by default. With a local server, your practice and IT provider are responsible for patching, backups, physical security and restores. With cloud software, the vendor runs the data center, but you still own access control, workstation security, email and your own backups of anything held locally.

HIPAA doesn't favor one or the other. HHS says a cloud service provider that handles ePHI is a business associate and needs a business associate agreement (HHS cloud computing guidance). CISA, writing for small businesses that struggle to keep internet-facing servers updated, encourages moving to reputable managed cloud providers to reduce, though not eliminate, maintenance work (CISA #StopRansomware Guide).

How does the choice change the build-out?

How FloorStack helps

The free FloorStack Studio plan starts from your software choice. Pick Dentrix, Eaglesoft, Open Dental, Curve or another system, and the plan tells you whether you need a server. If you do, it sizes the server from the vendor's published specs and builds the rack, power and backup layout around it. It's part of the FloorStack dental build-out platform. Start a free Studio plan, or see the Dental Office IT Setup hub.

Free tools on the FloorStack dental build-out platform for this step: Network & IT plan generator (free tool, coming soon).

Related guides: How to Back Up a Dental Practice: 3-2-1 and HIPAA (2026), Where to Put the Rack in a Dental Office: Heat, Noise, Access, Dental Office Network Design: A 2026 Planning Guide and Network Requirements for Dental Imaging and CBCT.

Free tools for this step

• FloorStack Studio (live, free plan): a 3D IT plan of your office with every device placed.
• Network & IT plan generator (free tool, coming soon): turn your floor plan into a drops, rack, Wi-Fi and VLAN plan.