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Do New Dental Practices Need a Server or Can They Go Cloud
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Ezra Angelo
- • May 18, 2026
New dental practices have an advantage established ones do not. You are not locked into a legacy system. You can choose from the beginning whether to build on a local server or go cloud-based.
That decision shapes your IT costs, your ongoing maintenance burden, and your infrastructure flexibility for years. Here is how to make the right call before construction begins.
The practice management software you choose determines whether you need a server. The decision is not about preference. It is about platform requirements.
Local Server vs. Cloud: What Each Model Actually Means
Select your practice management software to see which infrastructure model it requires and what the tradeoffs are.
Your selected software requires a dedicated Windows Server on-site.
A local server is a dedicated computer that runs your practice management software and stores patient data on-site. Every workstation connects to it. It is the traditional dental office infrastructure model and is still required by some platforms.
The upside: Performance independence. If your internet goes down, the server keeps running. Patient records, imaging, and scheduling continue without interruption.
Works without internet. Performance is local. No dependency on vendor uptime or connectivity.
$3,000 to $8,000 upfront cost. Ongoing patching and maintenance. Replacement every 5-7 years.
Your selected software runs entirely in the cloud. No server hardware to purchase or maintain.
Cloud-based practice management means your software and data live on external servers managed by your vendor. Staff access the system through a browser. The $5,000 to $8,000 server budget goes toward other opening costs or stays in reserve.
No upfront server cost. No ongoing server maintenance. Adding a second location is faster and less expensive than replicating server infrastructure.
Depends entirely on internet connectivity. A single connection is not sufficient. You need a primary connection and a backup (LTE failover or secondary ISP). Budget $50-$150/mo.
Your infrastructure model follows from your software choice. Decide the software first.
The most important question is which practice management platform fits your clinical workflow and specialty. Once that is decided, the server vs. cloud decision is made for you by the platform’s requirements. Your IT provider can then design the infrastructure around that choice.
The One Cloud Requirement That Catches New Practices Off Guard
Cloud-based platforms depend entirely on your internet connection. If the internet goes down, access to patient records, imaging, and scheduling goes with it. A single internet connection is not sufficient infrastructure for a cloud-based dental practice.
Every cloud-based dental office needs a primary internet connection and a backup connection -- typically a secondary ISP or an LTE failover device. Budget $50 to $150 per month for the backup connection. It costs far less than a day of downtime.
Does your planned location have a backup internet connection budgeted -- either a secondary ISP or an LTE failover device?
Your internet redundancy is planned. Good.
Confirm with your IT provider that the failover device is configured to switch automatically when the primary connection drops, not manually. Automatic failover means downtime is measured in seconds. Manual failover means downtime is measured in however long it takes someone to notice and act.
Add this to your budget before opening.
An LTE failover device costs $100 to $300 upfront and $50 to $150 per month. For a practice running a cloud-based PMS, a single connection failure during a patient day is a full practice outage. The backup connection is not optional infrastructure -- it is required for a cloud deployment to be reliable.
What About Imaging?
Dental imaging software often runs locally even when the practice management platform is cloud-based. Digital X-ray sensors, intraoral cameras, and CBCT scanners connect to a local workstation and store images on local or network storage.
Scheduling, patient records, billing, and treatment plans live on vendor servers. No server hardware required.
X-rays, intraoral images, and CBCT scans captured and stored on local workstation or network storage for performance.
A hybrid model where practice management is cloud-based and imaging is local is the most common setup for new practices going cloud. Your IT provider needs to design the network to support both environments working together reliably.
Frequently Asked Questions
Ekim IT Solutions works exclusively with dental practices. We serve New England and New York with on-site support and startup practices nationwide with remote support. We help new practices make the server vs. cloud decision based on their specific software choice, imaging setup, and long-term growth plans before the build-out begins.
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- • May 18, 2026
