Quick answer. Cloud based dental practice management software runs on the vendor’s servers and you use it in a browser or thin client. Server (on-premise) software runs on a computer in your office. Cloud means less IT and access from anywhere, with a monthly hosting cost and a dependence on your internet. Server means control and often a lower bill, with backups and security on you. Calibic reads server databases only and does not support cloud-only systems today.
The server is in the closet behind the sterilization room. It has a backup drive someone swapped in last week, or maybe last month. Then a vendor tells you cloud will fix all of that. Sometimes it will. This page shows what actually changes.
What is the difference between cloud and on-premise dental software?
With server software the database lives on a machine you own, and every workstation talks to it over your office network. You update it, back it up and secure it, or you pay someone to.
With cloud software the vendor hosts the database and you connect over the internet. In Dentrix Ascend, for example, you open it in a web browser from any device. Curve says it runs entirely in the browser with no local server.
There is also a middle option: hosted server software, where the same desktop product runs in someone else’s data center and you reach it through a remote session. Open Dental Cloud works this way and looks and feels like the local version, according to Open Dental.
Which systems are cloud and which are server?
| System | How it runs | Source |
|---|---|---|
| Open Dental | Your server, or Open Dental Cloud (hosted by Open Dental, US only, limited release) | Open Dental |
| Dentrix | Installed locally, practice managed | Dentrix |
| Dentrix Ascend | Cloud, in a browser | Henry Schein One |
| Eaglesoft | Server based, on premise | Patterson |
| Fuse (Patterson) | Cloud, aimed at multi-location practices | Patterson |
| Curve Dental | Cloud, in a browser, since 2004 | Curve |
| Denticon | Cloud | Planet DDS |
| CareStack | Cloud | CareStack |
You can pick the brand and the hosting model separately only where the vendor offers both. Open Dental is the clearest example, and Open Dental says you can switch from cloud to local hosting or back.
What changes for access?
Cloud wins here. Any device with a browser and a login works, so a doctor can check a chart from home. Henry Schein One lists “remote access” for Ascend and notes Dentrix does not offer it natively and needs a separate setup.
Server software can be reached from home too, through a VPN or remote desktop, but you build and secure that yourself. See Open Dental remote access and Eaglesoft remote access for the options.
What changes for backups?
On a server, the backup is your job. Check it three ways: it runs every night, it goes offsite, and someone has restored from it in the last year.
In the cloud the vendor owns the backup. Open Dental says its cloud backups are encrypted, tested for integrity nightly and stored offsite, and that staff restore the latest backup to a new server if one fails. That is a stated process. Ask any cloud vendor for theirs in writing.
What changes for speed?
It depends on your internet. Open Dental states that Open Dental Cloud needs at least 20 Mbps down, 10 Mbps up and latency under 30 ms to the data center. A fast server on a gigabit office network usually feels instant. A cloud system on a flaky connection does not.
Test before you sign: run a speed test at the front desk at 9 am on a busy day, and ask the vendor what to do when the line drops. Many offices keep a second line for this.
What changes for cost?
Server software has a small monthly fee and hidden costs: the server, a battery backup, backup storage, and IT hours. Cloud has a larger monthly fee and fewer hidden costs.
Worked example, Open Dental, one location, three years. Support is $199 x 12 + $149 x 24 = $5,964 on your own server. On the Small cloud package add $250 x 36 = $9,000 and $400 to migrate, for $15,364. The extra $9,400 buys you out of the server, the backup service and some IT time. If your server refresh and IT cost less than that over three years, local is cheaper. If not, cloud wins on cost too.
Other vendors mostly do not publish prices. CareStack lists plans from $829 per month per location. Dentrix, Dentrix Ascend, Eaglesoft, Curve and Denticon quote privately, so ask for the all in figure, including imaging and texting.
What changes for security?
Do not accept “cloud is safer” or “server is safer”. Ask who does the work.
- Cloud: the vendor patches, encrypts and monitors. Henry Schein One markets Ascend with SOC 2 Type II, TLS encryption and HIPAA readiness. Planet DDS says Denticon is SOC 2 Type 2. Ask for the report and a Business Associate Agreement. Open Dental offers a BAA to cloud customers.
- Server: you patch Windows, control who can log in remotely, and keep backups encrypted. This is where small offices slip.
The HIPAA Security Rule update proposed in January 2025 would make encryption and multi factor authentication required instead of optional. As of the sources I checked it was still a proposal, so treat it as a direction, not a rule.
What changes for reporting and analytics?
This is the part vendors skip. Your reports and any outside analytics tool depend on how they can reach the data.
- Server databases (Open Dental on MySQL or MariaDB, Dentrix desktop, Eaglesoft) can be read by a tool on your network. That is how Calibic works: read only, never writing a record.
- Cloud systems usually offer reporting inside the product, plus an API or approved integrations. Dentrix says its API is built for on-premise integrations, while Ascend integrations are fully remote.
If you buy cloud, ask: what can I read out, how often, and is there an extra fee?
Which one should I choose?
| Your situation | Lean toward |
|---|---|
| No IT person, old server, partners want remote access | Cloud |
| Several locations that need one view | Cloud, or a hosted option |
| Strong IT support, tight budget, happy with current software | Server |
| Unreliable or slow internet | Server |
| You want an outside tool to read your database directly | Server |
| You are unsure | Stay put and fix backups and remote access first |
What should be on my checklist before I move?
- Test the internet. Speed test at peak time, plus a backup line or a plan for outages.
- Get the all in price. Hosting, support, imaging, texting, conversion, per location.
- Ask for the exit. What format do I get my data in, and what does it cost?
- Check integrations. Sensors, payments, claims and reporting tools you use today.
- Check backups and security. Written backup process, SOC 2 report if claimed, and a BAA.
- Plan the cutover. A conversion date, a slow schedule and training. Denticon's FAQ cites about 60 days for a solo practice.
- Check your reporting. List the reports you run weekly and confirm each exists afterwards.
Where does Calibic fit?
Calibic is a read-only analytics layer, not a practice management system. It reads the databases of Open Dental, Dentrix desktop and Eaglesoft on your server. It does not support cloud-only systems today, including Dentrix Ascend, and it never writes to your software. If you plan to move to a cloud-only product, count that in your decision. If you are weighing systems more broadly, read how to choose dental practice management software.
What should I do next?
Write down your backup answer, your internet speed and your three year cost. If you are staying on a server system, see which systems and data Calibic covers.
Sources (checked 13 Oct 2026)
- Open Dental Cloud: https://opendental.com/site/opendentalcloud.html
- Open Dental fees: https://www.opendental.com/site/fees.html
- Dentrix vs Dentrix Ascend: https://www.dentrix.com/about-us/dentrix-or-dentrix-ascend/
- Curve Dental: https://www.curvedental.com
- Denticon: https://www.planetdds.com/denticon
- CareStack pricing: https://www.carestack.com/pricing
- Patterson Eaglesoft and Fuse (via search): https://www.pattersondental.com/fuse
- HIPAA Security Rule proposal: https://www.dwt.com/blogs/privacy--security-law-blog/2025/01/hipaa-security-rule-proposed-changes-in-2025