Cloud vs Server Dental Software: What Changes for Your Practice

The Short Answer

With server-based software, the database lives on a computer in your office. Patterson says Eaglesoft is an on-premise solution that requires a physical server, which stores and manages the practice’s database.^* Henry Schein One describes Dentrix as installed locally on office computers, with local servers managed by the practice.^*

With cloud software, the vendor runs the system for you. Open Dental describes Open Dental Cloud as a hosted solution managed by Open Dental Software, and Henry Schein One says Dentrix Ascend is accessed via web browser from anywhere.^*

Henry Schein One, Patterson and Open Dental each sell both kinds, and their own pages spell out the difference: who runs the server, who makes the backups, when updates arrive and how you reach the system from outside the office.

Where the Major Systems Run

From each vendor’s own website, checked September 28, 2026.

What a Server-Based System Asks of the Practice

The server is the computer that holds the database. Open Dental’s requirements describe it as the computer that runs the MySQL or MariaDB server program and stores the files and the database, and recommend a dedicated server to protect data; a backup battery (an uninterruptible power supply) is optional but recommended, to prevent data loss.^*

Looking after it falls to the practice. Henry Schein One lists IT and backups for Dentrix as practice-managed, and says Dentrix needs regular updates and IT support for backups and security.^*

Working away from the office takes extra setup. Henry Schein One says Dentrix does not offer remote access natively and requires remote access setups.^* For full read/write remote access to Eaglesoft, Patterson recommends a secure remote-access tool, with guidance from your office’s IT provider; Eaglesoft Mobile is primarily view-only.^*

What the practice gets in return is control. Henry Schein One says Dentrix gives you full control over your systems.^* Open Dental says its cloud version may not be a good fit for a practice that wants to choose when to update the software, wants to keep managing its own backups, or has the resources to manage a local server.^*

What Changes in the Cloud

Open Dental, which sells both, lists what its hosted version changes: it is available from anywhere with internet access, automatic nightly backups are handled by Open Dental, it is automatically updated with the latest features, and the practice is not reliant on IT for server or database upkeep or security.^*

Other vendors say much the same. Henry Schein One says Dentrix Ascend requires no local servers or IT maintenance, and CareStack says that because it is a 100% cloud-based solution, backups happen automatically.^* Patterson says that with Fuse you can access all of your practice and patient data anywhere you have an internet connection.^*

The computers in your office still need care. Open Dental notes that the local computers that access Open Dental Cloud are still fully managed by the practice or its IT.^*

What to Weigh

• Your internet connection. Open Dental says all you need for Open Dental Cloud is high-speed internet, and that it suits a practice with a reliable connection of at least 20 Mbps download and 10 Mbps upload, and latency below 30ms to one of its data centers.^*
• Updates. In the cloud they come from the vendor: Open Dental Cloud is automatically updated with the latest features.^* On a server, Henry Schein One says Dentrix needs regular updates.^*
• Integrations and features. A vendor’s cloud version can differ from its server version. Open Dental notes some limitations on interoperability with third-party solutions for Open Dental Cloud, and says its cloud users cannot use Voice Perio Charting.^*
• Backups and recovery. Ask who makes them, how often, where they are kept and how a restore works. For Dentrix, Henry Schein One lists backups as practice-managed; for Open Dental Cloud, Open Dental handles them.^*

How Cloud and Server Costs Compare

Compare the whole bill, not just the software. A server brings costs that may not appear on the software invoice: the machine itself, IT support, backups and any remote-access tool. With a cloud system, check what the subscription covers.

Open Dental publishes both prices, which makes it a useful example. Self-hosted, it is $199 a month per location for the first 12 months, covering up to three providers, then $149 a month.^* Open Dental Cloud is $430 a month per location for one provider, plus $150 a month for each additional provider and a one-time $400 migration charge.^*

For what Dentrix, Eaglesoft, Curve Dental, CareStack, Archy and CarifyOne publish about pricing, see our dental software cost guide. To total your own stack, run the savings calculator with your invoices.

Questions to Ask Before You Move

Our free switching checklist lists the reports to run from your current system before you switch and the questions to ask any vendor, on one printable page.

Where the software runs is one question among several. Our dental practice management software buyer’s guide covers the rest: what the software does, what it costs, how to switch and how the major systems compare.

Where CarifyOne Fits

CarifyOne runs the whole practice in the cloud, with no server in the back office. CarifyOne migrates from the major practice management systems, including Dentrix, Eaglesoft, Open Dental, Curve and CareStack. See how switching works.

Frequently Asked Questions