Dental Office IT Checklist: Software, Imaging, Backups

A dental office IT checklist has six parts: confirm what your practice management software officially supports, size the imaging and operatory computers to the imaging vendor’s specification, back up the database and the image store separately and test a restore, apply the HIPAA Security Rule’s technical settings on every workstation, keep patient Wi-Fi away from clinical devices, and write down which vendor owns which problem. The sections below turn each part into items you can check this week.

If you are looking for what we do for practices rather than a checklist, that is on the dental office IT services page. For the compliance overview (risk analysis, business associate agreements, the three safeguard families), read the HIPAA IT compliance guide. This post stays on the practical hardware, software, and settings.

What does your practice management software require?

The first fork is whether the software runs on a server in your office or in the vendor’s cloud. That single fact decides who is responsible for the database, what you have to back up, and how much a dead server costs you.

The table summarizes what each vendor publishes as of September 2026. Requirements change, so confirm against the linked document before buying anything.

Software	Where it runs	What the vendor documents
Dentrix	A Windows server in your office	Windows Server 2016 to 2025 for the server, 16 GB RAM, 1 Gbps network. Workstations: 8 GB minimum, 16 GB recommended. After June 30, 2026, Henry Schein One no longer supports installing Dentrix on Windows 10. Terminal Services and Citrix are not supported. (Dentrix System Requirements 2026)
Dentrix Ascend	Vendor cloud	Henry Schein One describes it as a cloud-based practice management system with imaging available inside the product. No database server in the office.
Eaglesoft	A Windows server in your office	Workstations must run Windows 11 Professional. Windows Home editions are not supported. Virtual machines are not supported. The server must be wired to the network. A dedicated server is recommended at 6 or more workstations. (Patterson hardware requirements, revised August 2026)
Open Dental	A MySQL or MariaDB database on a computer in your office (the vendor also offers a hosted version, Open Dental Cloud)	Supported: Windows 11 and Windows Server 2016 to 2025. Windows 10 is listed as no longer supported as of October 14, 2025. A dedicated server is recommended. (Open Dental computer requirements)
Curve Hero	Vendor cloud, used through a browser	The latest Google Chrome is the only fully supported browser. 8 GB RAM or more (16 GB recommended). Minimum 10 Mbps download and 5 Mbps upload for 1 to 10 users. Satellite and wireless internet service are not recommended. (Curve system requirements)

Three things stand out for anyone about to buy computers:

• Windows edition matters. A retail PC with Windows 11 Home is fine for Dentrix on paper (though Henry Schein One notes Home cannot join a domain, which limits security options) and is unsupported for Eaglesoft. Order Windows 11 Pro for every practice computer and the question goes away.
• Windows 10 is finished for dental use. Microsoft ended Windows 10 support on October 14, 2025, and the software vendors have followed. Paid Extended Security Updates exist for businesses at $61 per device for the first year, doubling each year for up to three years, but they only patch Windows. They do not make your practice software supported again. Our Windows 10 end of life guide covers the replacement decision.
• Cloud software moves the risk to your internet line. With Curve or Dentrix Ascend there is no server to fail, and no schedule without internet. A second connection that the firewall switches to automatically is worth pricing. The server versus cloud comparison walks through that trade-off.

Imaging, sensor, and operatory computers

Imaging is where general office IT advice stops being enough, because the sensor or scanner manufacturer controls the driver, and the driver controls what the computer can be.

Before replacing any computer that acquires images, get these answers in writing from the imaging vendor:

1. Which Windows version and edition the current driver and imaging software support.
2. Whether the device needs a specific USB controller or port type. Patterson, for example, recommends Intel USB chipsets for Schick sensors and states that one scanner model will not work with a particular chipset.
3. Whether the license is tied to the old computer and how it moves.
4. For 3D (cone beam CT, or CBCT) viewing, the graphics card and memory requirement for the reconstruction and viewing software. Do not assume an ordinary office PC qualifies.
5. Whether the imaging software bridges into your practice management software, and which versions of each are certified together.

Then apply the everyday rules:

• Wire the operatories. Henry Schein One’s requirements say wireless networks are used at your own risk because of potential interference from X-ray machines and other devices. Run Ethernet to every operatory and imaging computer.
• Turn off network adapter power saving on computers that stay open all day. Dentrix documents this as a fix for disconnect errors on idle workstations.
• Put the server and network gear on battery backup. Patterson recommends battery backups for all servers, tested twice a year.
• Keep antivirus on, with the vendor’s exceptions. Dentrix and Eaglesoft each publish the folders, programs, or ports to add as exceptions, and Patterson states that Windows Defender is supported with Eaglesoft. Use the vendor’s list rather than switching protection off.
• Check scanners and signature pads before buying. Patterson publishes lists of compatible and known incompatible document scanners for Eaglesoft. A scanner that works on any other office PC may not work with the practice software.

How much storage do X-rays and CBCT scans need?

There is no honest universal number, because it depends on the sensor, the scan volume, and the file format. Intraoral X-rays and camera photos are small. CBCT volumes are large, and a practice that scans regularly will outgrow a server sized for charts alone. Patterson’s own server specification notes that storing images may require a larger drive than its 1 TB baseline.

The practical method: ask the CBCT vendor for the typical size of one scan at the settings you use, multiply by scans per month and by how long you retain them, then add headroom for growth. Remember that every backup copy needs the same space again. Check where the imaging software actually saves files. It is often a separate folder or a separate database from the practice management data, which matters for the next section.

Backups: what a dental office actually has to copy

For server-based practices there are usually three separate things to protect, and each one needs to be named in the backup job:

What	Where it usually lives	Note
Practice management database	The server	Often needs the vendor’s export or a database-aware backup. Copying open database files can produce a backup that will not restore.
Image store	A folder or second database, sometimes on a different drive	Largest by far. Confirm it is in the backup scope by name.
Everything else	Shared folders, scanned documents, templates, email	Easy to forget because it is not “the dental software.”

A sound arrangement keeps one backup in the office for fast restores and one encrypted copy off site, with the off-site provider under a signed business associate agreement. The HIPAA Security Rule lists a data backup plan and a disaster recovery plan as required parts of contingency planning, so this is not optional housekeeping.

The test that counts is a restore. Twice a year, restore the database and a sample of images to a spare computer, open a chart, and open an X-ray. Write down how long it took. That number is your real downtime if the server dies. The general method is in our business data backup guide.

Cloud practices are not exempt. The vendor protects its platform, but ask how you would export your own data, and remember the office still has scanned documents, email, and local files of its own.

The HIPAA settings to verify on every workstation

The Security Rule’s technical safeguards are written as goals. Here is what they translate to on a dental office PC:

• Unique user identification (required). Every person signs in to Windows and to the practice software with their own account. No shared “operatory” password. Shared logins make the audit trail meaningless.
• Automatic logoff (addressable). Set screens to lock after a short idle period. In a domain this is the Windows policy “Interactive logon: Machine inactivity limit.” Operatory screens that face the chair deserve the shortest timer.
• Encryption (addressable). Turn on BitLocker, the drive encryption that Microsoft includes with Windows Pro, on every laptop and on the server, and store the recovery keys somewhere other than the device itself.
• Audit controls (required). Confirm the practice software’s audit log is on, and know who reviews it and when.
• Authentication. Require multi-factor authentication (a second proof, such as an app prompt) on email, remote access, and any cloud practice software. CISA recommends it for email, file storage, remote access, and administrator accounts.

“Addressable” does not mean optional. It means you implement the measure if it is reasonable and appropriate, or document why not and use an equivalent. For encryption and screen locks on a dental workstation there is rarely a reason not to.

Two more items belong to the physical safeguards but land on IT. Staff should not have local administrator rights on operatory PCs, and when a computer or server is retired, the drive must be wiped or destroyed first, because the rule requires procedures for disposal and media re-use. A retired imaging PC can still hold patient X-rays in a local folder or cache.

HHS proposed a stricter Security Rule in January 2025 that would make encryption and multi-factor authentication mandatory. It has not been finalized. The existing rule is what applies today. This is IT guidance, not legal advice.

Network layout for a dental practice

A simple, defensible layout uses three separate networks on one firewall:

1. Clinical and office: server, front desk, operatories, imaging devices, printers.
2. Payment terminals, if your processor’s instructions require isolation.
3. Patient guest Wi-Fi, which reaches the internet and nothing else.

Separate Wi-Fi names alone do not prove isolation. After setup, connect a phone to the guest network and confirm it cannot see the server or a printer. Our network segmentation guide explains how the separation works. Networked imaging units often need a fixed address so the acquisition computer can always find them, so record those addresses in the inventory.

Who owns which problem?

A dental outage can involve several companies at once. Deciding ownership in advance means nobody spends the first hour working out who to contact.

Problem	First contact	IT’s part
Practice software error, update, or database repair	Software vendor support	Confirm the server, network, and Windows are healthy. Provide remote access for the vendor.
Sensor not detected, imaging bridge broken	Imaging vendor	Check USB, drivers, Windows updates that landed the night before, and permissions.
Computer will not start, printer offline, Wi-Fi down	IT	Own it end to end.
Card terminal declines or disconnects	Payment processor	Verify network path and firewall rules.
Internet outage	Internet provider	Fail over to the second line, open the ticket, track it.

Keep one page with every vendor’s support contact, your account numbers, and who in the practice is authorized to approve changes. Practice software vendors also sell their own hardware and backup services. Those are a legitimate option. The checklist here applies whichever route you choose.

The checklist on one page

• Every computer runs Windows 11 Pro and is on the vendor’s supported list
• Practice software version is one the vendor still supports
• Imaging vendor has confirmed requirements for each acquisition and 3D viewing PC
• Operatories and server are wired, not on Wi-Fi
• Server and network equipment are on battery backup
• Database, image store, and shared files are each named in the backup scope
• One encrypted off-site backup under a business associate agreement
• Restore tested in the last six months, time recorded
• Unique logins, idle screen lock, BitLocker, and multi-factor authentication in place
• No staff local administrator rights on clinical PCs
• Guest Wi-Fi tested and isolated
• Vendor contact sheet and device inventory are current
• Departed staff removed from Windows, practice software, email, and remote access
• Old drives wiped or destroyed, with a record

When you do not need all of this

A single-dentist practice on cloud practice software with two or three computers has no server to maintain and no local database to back up. For that office the list shrinks to supported Windows 11 Pro computers, encryption, multi-factor authentication, wired operatories, an isolated guest network, a second internet option, and clean staff offboarding. Spending on a server, a domain, or heavy monitoring would add cost without reducing much risk.

The full list earns its keep once there is a server, CBCT, or more than a handful of workstations.

Common questions

Can we keep using Windows 10 computers in the operatories?

Not safely. Microsoft stopped patching Windows 10 on October 14, 2025. Open Dental lists it as no longer supported, Eaglesoft’s current requirements list only Windows 11 Professional for workstations, and Dentrix no longer supports new installs on it. An unpatched computer holding patient data is also hard to defend in a HIPAA risk analysis.

Is cloud dental software safer than a server in the office?

It removes some risks and adds others. You no longer maintain a server or a local database backup, and the vendor handles patching. In exchange, the practice depends entirely on its internet connection and on account security, so multi-factor authentication and a backup internet line become the priorities.

Do we need a dedicated server or can the front desk PC be the server?

Small Dentrix and Open Dental offices can run the database on a workstation, and both vendors allow it. Patterson recommends a dedicated Eaglesoft server at six or more workstations. A shared machine saves money but means a front desk crash or reboot stops every operatory, so weigh that against the cost of a modest dedicated server.

How long does a dental server replacement take?

It depends on the software vendor’s migration process, so ask them first. The work includes moving the database with the vendor’s help, pointing each workstation at the new server, reconnecting imaging bridges, and testing every operatory. Schedule the cutover outside patient hours and keep the old server untouched until a full day of patients has gone smoothly.

How we can help

Coastal Growth Co. handles the computers, network, accounts, and backups around your dental software, and coordinates with your practice management and imaging vendors on the parts they own. We can work through this checklist with you, document what we find, and scope any fixes before paid work begins. See the dental office IT services page or our network and security services, then tell us what you are working with. Please leave patient information out of the message.