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How to Evaluate Dental Software for a Startup Practice
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Ezra Angelo
- • May 21, 2026
The practice management software decision is the one we see cause the most downstream problems when it is made without the right evaluation criteria. A startup practice choosing software based on familiarity from residency, a sales rep’s recommendation, or a single colleague’s experience often discovers six months after opening that their platform requires infrastructure they did not budget for, does not integrate with the imaging system they purchased, or creates vendor dependencies they were not prepared for.
Ekim IT Solutions is the dental-exclusive IT provider that sets up IT infrastructure for new dental practices across Maine, New England, Tampa Bay, and nationally.
Here is the evaluation framework Ekim IT Solutions walks startup practices through before they commit to a platform.
The practice management software decision determines your IT infrastructure model, your imaging integration options, your HIPAA compliance approach, and your growth flexibility for years.
Criterion 1: Server vs. Cloud
The first evaluation criterion is whether the platform requires a local server or runs cloud-based. This is not a preference question. It is an infrastructure cost question. Dentrix and Eaglesoft require a Windows Server, which adds $3,000 to $8,000 in hardware cost plus ongoing maintenance. Curve Dental, Dentrix Ascend, CareStack, and cloud-deployed Open Dental require no local server. Open Dental supports both models. Answer this question first because it determines your buildout cost and your IT maintenance burden for the life of the practice.
Criterion 2: Imaging Software Compatibility
Confirm these three imaging compatibility questions before purchasing any PMS.
Does the PMS integrate natively with your chosen imaging platform, or does it require a TWAIN bridge?
Does the PMS support the specific sensors, cameras, and CBCT units you plan to use, at the model level, not just the brand?
Has your IT provider configured this exact PMS-imaging combination before?
Criterion 3: Growth and Multi-Location Flexibility
A startup practice that plans to add a second location in three years is evaluating software differently than a practice that will stay single-location indefinitely. Server-based platforms require replicating server infrastructure at each new location. Cloud-based platforms add locations without hardware procurement. DSO-oriented platforms like Denticon and CareStack are built for multi-location from the ground up. If growth is a defined goal, evaluate the platform against your three-year plan, not just your day-one needs.
Criterion 4: Vendor Lock-In and Data Portability
Practice management software vendors vary significantly in how easily they allow practices to export their data if the practice wants to switch platforms later. Open Dental, as an open-source platform, gives practices full access to their database in a standard SQL format. Proprietary platforms may restrict data exports or charge significant migration fees. For a startup practice, this is a longer-term consideration, but it is worth understanding before committing to a platform with restrictive data portability.
Criterion 5: HIPAA Compliance Support
Every practice management software vendor must sign a Business Associate Agreement with the practice before any patient data enters their system. Confirm BAA availability before purchase. Beyond the BAA, evaluate whether the platform provides audit logging, configurable access controls, and encryption at rest. These are HIPAA technical safeguard requirements that your platform must support. Ekim IT Solutions reviews the HIPAA documentation provided by any PMS vendor before recommending them to a startup practice.
Frequently Asked Questions
Ekim IT Solutions sets up IT infrastructure for new dental practices across Maine, New England, Tampa Bay, and nationally. We walk startup practices through the evaluation framework before they commit, so it doesn’t turn into a six-month surprise.
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- • May 21, 2026
