A local server suits a Seattle office that uses imaging, voice perio or letter merge heavily, and the vendor's cloud suits one with a strong internet line and no appetite for running a server. The vendor's own checklist decides most cases. The desks need the same care either way.
Last updated: November 2026
Does Open Dental have a cloud version?
Yes. Open Dental Cloud is a hosted service managed by the vendor. It is only available to US customers and is currently in limited release, so the vendor accepts a limited number of customers and gives preference to those whose situation is a good match. The first practical step is therefore a phone call to the vendor. There is no point planning around a service until it has said yes.
A third route exists, and it often gets confused with the first two. A practice's IT company can run the program on a virtual server it rents from a cloud provider, connected through the vendor's Middle Tier. The vendor says that option requires the practice's IT company to set up and maintain the hosted server, and that it needs a good internet connection, a VPN, secure certificates and a cloud storage server. It removes the box from the closet without removing any of the work.
Which is better, cloud-based or server-based?
Neither is better in general. The vendor's fit list comes closest to a fair test, and it reads as a set of trade-offs.
| Question | Good fit for the vendor's cloud | Poor fit for it |
|---|---|---|
| Computers | The practice uses Windows | The practice uses macOS |
| Internet line | Reliable, at least 20 Mbps down and 10 Mbps up | Unstable, or below those speeds |
| Latency to a vendor data center | Below 30 ms to at least one | Above 50 ms |
| Updates | Wants the latest tools | Wants to choose when to update |
| Backups | Wants them automated | Wants to keep managing them |
| Running a server | No resources or desire to | Has the resources |
| Integrations | Uses the program's online services | Relies on third-party tools outside the vendor's API |
| Imaging | Separate imaging that does not need hosting | Wants separate imaging hosted by the vendor |
A practice that lands mostly in one column has its answer. A mixed result usually comes down to the features below.
What stops working in the hosted version?
The vendor publishes a differences page, and it is the most useful page in this whole decision. Take it to the people who do the work, because the front desk and the hygienist will spot what a spec sheet will not.
- Clinical: voice perio charting is unavailable. Video capture and automatic import are unavailable in imaging, and PDF controls such as zoom are limited.
- Front office: Letter Merge and internal Chat are not available, manual ERA downloads are gone, and touch screens are not supported for signatures.
- Documents: the document folder is not local, so anything normally imported from it comes from the workstation instead, which affects email attachments and the attachment service.
- Backups: the Backup Tool and supplemental backups are not available, because the vendor runs the backups.
- Setup: Choose Database is read-only, and the Update Server preference is disabled. Printer Setup cannot be reached either, according to the printer page.
- Advanced: HL7, EHR and replication setup are absent, as is the standalone wiki.
Updates arrive automatically, or by appointment with support for one outside the normal cycle. An office that holds off on updates because an imaging bridge is fragile should think hard about that line.
What happens in a Seattle outage?
This is where local conditions change the argument. Consider three events, and what each setup does.
The power goes out at the office
With a local server, the battery shuts it down cleanly and everything stops until the power is back. The hosted version does not help as much as people expect either: the data is safe and running somewhere else, but the computers at the desks are off. A laptop on a phone hotspot might reach a hosted schedule, which is a real advantage for phoning patients on a bad day. It does not treat anyone.
The internet line drops
Here the two split sharply. A local server carries on, since charts and images travel over the office's own network; only the online services and electronic claims pause. In the hosted version, nothing opens until the line returns, and the schedule goes with it. Someone choosing hosting should therefore ask about a second line from a different provider, with the other provider's route confirmed in writing where possible.
A regional event
The city's emergency managers call earthquakes Seattle's most serious hazard, and place the Seattle Fault Zone through the middle of the city. This is the hosted version's strongest case. The vendor says hosted backups are encrypted, tested for integrity nightly and stored off-site, and that after a server failure its staff restore the latest backup to a new server. A local server can match that, but only if someone designs it: an encrypted copy outside the region, restored on a schedule. Without that, a local server in a damaged building takes the only copy of the practice's records with it.
What do the state's rules change?
Moving the database does not move the duty. RCW 19.255.010(2) requires a business that maintains data it does not own to notify the owner immediately after discovering a breach. The host tells the practice, and the practice still tells its patients. So any hosting or backup agreement should say who calls whom, and at which number, and that goes in the file before the move.
Record keeping travels too. WAC 246-817-310 has a dentist keep readily accessible records for at least six years from the last treatment. The practice should know how it would get a full copy of its data out of any host, and should confirm that answer before signing. Plan for the end of the arrangement at its start. The vendor says switching between its cloud and a local server is possible, in either direction.
What stays on the practice's side either way?
More than people assume. The vendor says the local computers that reach its cloud are still fully managed by the practice or its IT. So a move to hosting still leaves the following in the office:
- every workstation, with its Windows updates, antivirus and logins;
- sensors and their drivers, tested at the chair;
- printers, card terminals and scanners;
- the internet line and any backup line, which stay between the practice and its provider.
The first three are the jobs ClearMax technicians do on site under either answer. Cabling, cameras and door hardware are done by your licensed local contractor, in a new office or an old one, and network hardware stays with that contractor too.
How is the decision actually made?
- List what the office uses from the vendor's differences page, and ask each person who uses it.
- Measure the line at a busy time: download, upload, and latency to the vendor's data centers.
- List every third-party tool, then check each against the vendor's list of compatible integrations.
- Call the vendor and ask whether the practice can be accepted, and get the official quote, which it provides before signup.
- Write down the remaining life of the current server. One due for replacement anyway makes this the natural time to decide.
If the answer is local, the hardware requirements page sizes the machine, and the server migration page covers the move. A practice with mostly new computers needed either way can start with the computer setup page.
Others weighing this have asked
Does Open Dental require a server at all?
Not on its hosted version. A locally installed multi-computer office does need one machine holding the database and the shared files, and the vendor recommends that it be dedicated.
Can we try hosting and come back?
The vendor says switching between cloud and local hosting is possible both ways. Treat it as a migration, with a tested backup in hand.
Which costs less?
The vendor quotes hosting by package before signup. Compare that over the server's whole working life, including the machine, Windows licences, backups and the people who look after them. A quote built from the practice's own details supplies the local side of that comparison.
Is hosting more secure?
Not automatically. It moves the server work to the vendor; the logins, phishing and unpatched desks stay in the office.