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The practice management system (PMS) ties together scheduling, clinical charting, the patient ledger, claims, and recall. Products differ in two important ways: server-based versus cloud architecture, and single-office versus multi-location design. A dental support organization (DSO) should pay particular attention to how the product handles multiple locations and legal entities. Vendors change ownership, rebrand, and reposition frequently. Verify current capabilities directly, and test multi-location support with your actual entity structure before signing. See Choose a PMS.

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The directory

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Important product notes

  • Dentrix to Ascend is a conversion, not an upgrade. Ascend is a separately built cloud product on its own codebase; moving means a data migration and retraining, the same as moving to any other vendor.1
  • Open Dental’s license changed at v24.4 from GPL to a proprietary license, with no announced pricing change. DSOs that built internal tooling against the source code should re-read the license before their next upgrade. Database read access and the API remain the supported integration paths.5
  • Denticon’s enterprise figures come primarily from Planet DDS. The company reports 14,500 practices, extensive adoption among groups with more than 100 locations, and use by more than half of the 60 largest North American DSOs. Its July 2026 DentalOS release brings Denticon and Cloud 9 together at the platform level.8 Independent coverage describes meaningful enterprise adoption, but buyers should still verify the vendor’s figures with customer references.
  • Server-based systems require local infrastructure. A group may need a Windows server at each office, a hardware replacement schedule, and networking that supports access across sites. Cloud products can reduce that burden by providing one patient database and centralized scheduling and reporting.1
  • Some DSOs run Open Dental at scale using hosted MySQL and the product’s data-access options. The group may need to build parts of its own cross-location reporting and administration rather than receiving them as native features.

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What to test in every demo

  1. A common dental encounter from start to finish: exam, radiographs, treatment plan with a downgrade-aware estimate, and claim
  2. Multi-entity: several Tax IDs, several group NPIs, per-entity settlement and reporting
  3. 837D submission and attachment handling: which clearinghouses it supports and whether you can change them (see the clearinghouse comparison)
  4. A difficult 835 containing a takeback, interest, and a secondary transfer, including how each item appears in the exception queue
  5. Your KPI reports, including hygiene reappointment rate, recall compliance, production by provider, and PPO write-off by plan, without exporting to a spreadsheet
  6. Data export: what, how, how fast, at what cost

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Sources

  1. Henry Schein One, Dentrix or Dentrix Ascend.
  2. Henry Schein One, Dentrix Ascend.
  3. Patterson Dental, Eaglesoft.
  4. Patterson Dental, Fuse; launch announcement, Business Wire, April 2018.
  5. Open Dental, License.
  6. Open Dental, MySQL documentation; market overview at dentistpms.com.
  7. Curve Dental, DSO page and Fast facts (vendor pages).
  8. Planet DDS, Denticon; Planet DDS release via Yahoo Finance (vendor-sourced figures); independent review at The Molar Report; DentalOS coverage, John Flucke, July 2026.
  9. tab32, Open Dental alternative page (vendor page); roundup at SoftSmile.
  10. Archy, archy.com; Series A announcement, PR Newswire, 2024; Pearl AI integration, Dentistry Today.
  11. Oryx, comparison pages and oryxdentalsoftware.com (vendor pages).
Last modified on August 21, 2026