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Last Updated: November 2026
You moved your practice software to the cloud. So, the server in the supply closet can finally go, right?
For the software itself, often yes. But your X-rays, 3D scans, and a few other tools may say otherwise. Get it wrong, and your first patient on Monday morning is in the chair with no way for you to pull up their images.
Here’s what to check first, and how to tell which side of the line your practice is on. If you’re planning a move to cloud solutions, or you’ve already made one and wonder what’s left in the closet, this is for you.
Check these three things first
- Your imaging software. Does it save to the cloud, or does it still expect a server in your office?
- Your 3D (CBCT) scans. Where do they save, and can your internet send them without a traffic jam?
- Your internet. Do you have a backup connection for the day your main line goes down?
The rest of this article shows you how to answer each one.
Can I get rid of the server in my dental office if I move to the cloud?
Often yes, for your practice management software. But many offices still keep a small server for imaging. Cloud practice management software, such as Dentrix Ascend, Curve Dental, Denticon, tab32, or vendor-hosted Open Dental Cloud, keeps your schedule, charts, and billing on the vendor’s server, so you no longer need your own server for those. Your X-ray sensors, 3D scanner, and cameras still plug into computers in your building, though. And where those images live is the part most practices miss.
What does “no server” mean?
It means no database server for your practice management software. That’s all. You still own and care for:
- The computers that run the software
- The small connector programs (often called “bridges”) that link sensors and cameras to it
- The internet line that everything now depends on
Cloud vendors say this themselves [6]. The computers that reach their cloud remain the practice’s job to manage and secure. The server moves, but the responsibility doesn’t.
What do popular cloud platforms still expect from your dental office?
A lot more than “just a browser.” Here’s what several well-known platforms list in their own requirements. Speeds assume the number of users shown, and vendors update these figures, so check the current numbers before you buy.
| Platform | Internet speed the vendor lists | What you still manage in the office |
|---|---|---|
| Dentrix Ascend [5] | 50 Mbps down / 10 Mbps up for ten simultaneous users at one location | Chrome browser, 8 GB RAM minimum (16 GB recommended), and an imaging capture agent on capture computers |
| Curve Dental [4] | 10 Mbps down / 5 Mbps up for 1 to 10 users. Satellite and wireless internet not recommended | Chrome browser, 8 GB RAM minimum (16 GB recommended), and capture software on the computer wired to your devices |
| Open Dental Cloud [6] | 20 Mbps down / 10 Mbps up, with low delay (latency under 30 ms preferred) | A Windows computer running a bridge program to connect imaging and other software |
| Denticon [7] | 6 Mbps down / 2 Mbps up recommended for the software alone, before imaging | Windows 11 recommended, with 16 GB RAM |
| Apteryx XVWeb (cloud imaging) [8] | 20 / 10 Mbps minimum, 40 / 15 Mbps recommended | Local capture software and a bridge to your sensors |
tab32 also advertises a fully cloud-based setup with no local server [9]. Even so, its sensors still connect to computers in your office.
“Cloud” cuts the server, but it doesn’t cut the work of keeping your computers, connections, and internet in working order.
What moves to the cloud, and what stays?
| Piece of your practice | Usually moves to the cloud | Often stays in the office |
|---|---|---|
| Charts, schedule, billing | Yes | No |
| Intraoral X-rays and images | Yes, if your imaging is cloud-native | Sometimes, if you use legacy (older) imaging software |
| 3D (CBCT) scans | Sometimes | Often, because the files are large |
| Sensors, cameras, scanners | No | Always (the plug in locally) |
| Backups of anything stored on site | Partly | Yes, plus an off-site copy |
Not sure which column your practice falls in? The next section helps you sort it out.
Does digital imaging still need a server?
Sometimes. It depends on your imaging software, not your practice management software. Cloud-native imaging can save images straight to the cloud. Older imaging programs were built around a server in your office, and they still expect one.
Which imaging setups need an on-site server?
| Your imaging setup | Server needed? | Why |
|---|---|---|
| Cloud-native imaging with sensors, pano, and cameras (for example, DEXIS with Dentrix Ascend, Apteryx XVWeb, or Curve Dental’s built-in imaging) | Usually no | Images save to the cloud. A connector program on the capture computer does the hand-off. |
| Legacy (older), server-based imaging software (for example, Sidexis 4, CS Imaging, or classic on-site DEXIS) | Yes | It runs on a local database and a shared image folder. Manufacturer guides call for a dedicated server and a wired gigabit network [3]. |
| CBCT (3D) with its own software | Often a small one | The files are big, and the unit’s software may expect local storage. |
| Intraoral scanner or in-office milling | Usually no server | It needs a strong, dedicated computer instead. |
Notice the pattern? The server isn’t there for your practice management software anymore. It’s there for the images.
How big are 3D scans, really?
Big enough to matter. A standard intraoral X-ray is tiny, a panoramic is bigger, and a 3D (CBCT) scan can run into the hundreds of megabytes. A CBCT reading service’s guide indicates scans can run anywhere from 50 MB to 1 GB depending on the field of view size [2].
A large 3D scan (often several hundred MB) on a 10 Mbps upload line can take five minutes or more to send, even with nothing else using the connection. Add a full schedule of patients, and the line gets crowded fast.
How to avoid it
Before you retire the server, ask your imaging vendor three things in writing:
- Does my exact sensor, pano, and CBCT model work with the cloud setup I’m choosing?
- Where do my 3D scans save, and how fast do they upload on my internet plan?
- What happens to image capture if my internet drops?
What do I still need if I go server-free?
A strong internet connection, a backup plan for that connection, and well-protected computers. When your software lives in the cloud, your internet connection becomes your server. If it’s slow or down, it’ll affect the whole office.
Your server-free checklist
- Business-grade internet sized for your staff and your image uploads
- A second internet path that switches on automatically (a different provider, or a cellular backup on your firewall)
- A business firewall, managed switches, and strong Wi-Fi that cover every operatory
- Updated computers. Support for Windows 10 ended in October 2025, so plan on Windows 11 with enough memory for your software and imaging
- Battery backups (UPS) on your firewall, modem, switches, and capture computers
- Security on every computer: updates, encryption, threat monitoring and response, multi-factor login, and phishing training for your team. Network security matters more when every computer is a doorway to your cloud.
- Backups for anything still stored on site, your email, and your documents. Learn more about backup and disaster recovery.
What happens when the internet goes down?
With cloud-based practice management software, your software stops until the connection comes back. That’s the trade-off. Fast, simple, and always up to date, but only as reliable as your line.
So, plan for it before it happens. Write down what your team does in the first five minutes of an outage:
- Switch to your backup internet connection
- Pull up the printed schedule you saved that morning
- Use paper forms for notes and consents
- Forward the main phone line to a mobile number
- Call your IT team
Test your backup connection every quarter, because you never know when you’ll need it. Want the full playbook? Our guide to dental practice business continuity during an IT outage includes HIPAA-safe offline steps and a free printable outage checklist.
Do I still need backups if my vendor hosts my data?
Yes, for anything that isn’t hosted. Your vendor protects the data it hosts. You protect everything else: local imaging files, scanned documents, email, other applications, and configurations. For the ransomware side, see our guide to ransomware and HIPAA. Federal guidance says to test restoring your backups on a regular schedule and to keep a copy that ransomware can’t reach [11]. The ADA gives similar advice: back up regularly and keep an encrypted copy off site [1].
Does moving to the cloud change my HIPAA responsibilities?
Not really. The data moves, but the responsibility stays with you. A cloud vendor can host your records, but it can’t take on your HIPAA duties for you. Here’s what to check:
- Signed agreements. Federal guidance says a cloud provider that handles patient information is a business associate. That’s true even if it can’t see your data because it doesn’t hold the encryption key [10]. Get a signed business associate agreement (BAA) from every vendor that touches patient data.
- A written contingency plan. The HIPAA Security Rule requires a data backup plan, a disaster recovery plan, and an emergency-mode plan [12]. For a cloud office, that plan has to cover internet and vendor outages.
- Encryption and multi-factor login. Today, encryption is an “addressable” safeguard under the rule [13]. A proposed update would make encryption and multi-factor login required, but it isn’t final. Don’t wait. Both are smart protection now.
This isn’t legal advice. Pact-One is security-first, with HIPAA as a top priority, and we help practices support their HIPAA compliance. Your attorney or compliance advisor should confirm what applies to you.
Should my practice keep a server or go server-free?
Go server-free if your software and your imaging are both truly cloud-based. Keep a small, focused server if your imaging or 3D scans still need one. Here’s a quick way to sort yourself:
| You can likely go server-free if… | You likely need a small server if… |
|---|---|
| Your practice software is vendor-hosted | You run legacy (older), server-based imaging software |
| Your imaging saves natively to the cloud | Your CBCT software expects local storage |
| Every sensor and camera is confirmed compatible, in writing | You need read-only access to an old system or archive |
| You have fast, reliable internet and a backup connection | Your internet is slow or unreliable, with no second option |
| Your shared files already live in a secure cloud service | A specialty program you rely on isn’t cloud-ready |
If you do keep a server, keep its job narrow. Use it for imaging only, keep it under warranty, plan to replace it every five to seven years, and back it up off site. If yours runs Windows Server 2016, its support ends January 12, 2027.
How do the two options compare?
| Cloud, no server | On-site server | |
|---|---|---|
| Upfront cost | Lower | Higher (hardware and setup) |
| Ongoing cost | Monthly subscription plus backup internet | Support, backups, licenses, and replacement |
| Internet outage | Software stops until you’re back online | Charting and imaging keep working locally |
| Hardware failure | Vendor’s job for hosted data | Your job to fix |
| Remote and multi-location access | Built in | Needs secure remote access |
| Updates | Automatic | You choose the timing |
On cost, the honest answer is that it depends. Add up the server, its replacement, backup services, and IT time. Then add the cloud subscription and the backup internet line. Ask for real quotes before you decide.
How do I decide without guessing?
Start with a clear picture of what you have. You didn’t get into dentistry to become an IT expert, and you shouldn’t have to guess about servers, bridges, and bandwidth. Here’s a simple three-step plan:
- Map it. List your imaging devices, software, computers, and internet plans.
- Check the gaps. Confirm compatibility, upload speed, backups, and security for each piece.
- Choose your path. Retire the server, shrink it to an imaging-only job, or keep it. Then build the backup plan around that choice.
Get this right, and the technology fades into the background. Your team captures images without a hitch, your schedule stays full, and nobody is hunting for a cable during a patient visit.
As a dental-exclusive IT partner since 2003, Pact-One walks through these steps with practices every day. Our team knows your imaging, software, and daily workflow, and there are no long-term contracts after the first year.
Considering moving to the cloud? Schedule a Dental IT Service Comparison Call to talk with a dental IT specialist about where your setup stands and whether a server still makes sense for your practice.
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Not ready for a call? Take the 1-minute free IT Health Assessment and see where your practice stands today.
Frequently Asked Questions
Can a dental practice run with no server at all?
Yes, if your practice management software and your imaging are both cloud-based and every device is confirmed compatible. You’ll still need good computers, a firewall, cybersecurity, and a backup internet connection.
Do I need a server for a CBCT machine?
Often, a small one. CBCT files are large, and some units’ software expects local storage. Ask your manufacturer where scans save and how long they take to upload on your internet plan.
Will my current X-ray sensors work with cloud software?
Usually, but not always. Compatibility depends on the exact sensor model, its driver, and the computer it plugs into. Get a written confirmation before you switch.
What happens to my practice if the internet goes down?
With cloud software, your practice management software pauses until the connection returns. A backup internet line and a written downtime plan keep your day moving.
Does cloud software make my practice HIPAA compliant?
No. It can support your compliance, but the duty stays with you. You still need signed vendor agreements, a contingency plan, and secure computers.
Is going server-free cheaper?
It can be, but not always. Compare the full cost of a server over its lifetime against the cloud subscription plus backup internet. Ask for real quotes.
Dental IT, Be Worry-Free
Pact-One takes IT completely off your plate – cybersecurity, data backup & recovery, and day-to-day support – so you can get back to running your practice. Dental IT exclusively since 2003.
Whether you’re looking for dental IT services for your startup or searching for more responsive dental IT support – our team of dental IT specialists has you covered. With team members throughout the United States, we offer nationwide support to dental practices of all sizes, specialties, and stages of growth. Our wide range of dental IT services ensures your data is secure, accessible, and protected.
Don't let technology challenges hinder your ability to deliver exceptional dental care. Contact us at info@pact-one.com or 866-722-8663 to join over 3,000 dental professionals thriving with the support of a dedicated dental IT team.
Sources
- American Dental Association. “How to Protect Your Dental Practice from Cyberattacks.” ADA News, Mar. 2023, https://adanews.ada.org/ada-news/2023/march/how-to-protect-your-dental-practice-from-cyberattacks. Accessed 12 Nov. 2026.
- BeamReaders. “Understanding DICOM Export Requirements.” BeamReaders Help Center, https://help.beamreaders.com/a-62-understanding-dicom-export-requirements. Accessed 12 Nov. 2026.
- Carestream Dental. CS Imaging 8 System Requirements. Rev. May 2026, https://www.carestreamdental.com/globalassets/resource-library/software/imaging-software/cs-imaging/v8/sma75-cs-imaging-8-system-requirements-ed07.pdf. Accessed 12 Nov. 2026.
- Curve Dental. “Hardware Requirements.” Curve Dental, https://www.curvedental.com/system-requirements. Accessed 12 Nov. 2026.
- Dentrix Ascend Support. “System Requirements.” Dentrix Ascend Help Center, https://hsps.pro/DentrixAscend/Help/System_requirements.htm. Accessed 12 Nov. 2026.
- Open Dental Software. “Open Dental Cloud Requirements.” Open Dental, https://opendental.com/site/opendentalcloudrequirements.html. Accessed 12 Nov. 2026.
- Planet DDS. “Denticon System Requirements.” Planet DDS, https://www.planetdds.com/denticon-system-requirements-denticon/. Accessed 12 Nov. 2026.
- Planet DDS. “XVWeb System Requirements.” Planet DDS, https://apteryximaging.planetdds.com/hc/en-us/articles/30152245740187-XVWeb-System-Requirements/. Accessed 12 Nov. 2026.
- “All-in-One Dental Software Platform.” tab32, https://tab32.com/platform/. Accessed 12 Nov. 2026.
- U.S. Department of Health and Human Services. “Guidance on HIPAA & Cloud Computing.” HHS.gov, https://www.hhs.gov/hipaa/for-professionals/special-topics/health-information-technology/cloud-computing/index.html. Accessed 12 Nov. 2026.
- U.S. Department of Health and Human Services. “Ransomware Fact Sheet.” HHS.gov, https://www.hhs.gov/hipaa/for-professionals/security/guidance/cybersecurity/ransomware-fact-sheet/index.html. Accessed 12 Nov. 2026.
- Administrative Safeguards. 45. C.F.R. 164.308. Electronic Code of Federal Regulations, https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-C/section-164.308. Accessed 12 Nov. 2026.
- Technical Safeguards. 45 C.F.R. 164.312. Electronic Code of Federal Regulations, https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-C/section-164.312. Accessed 12 Nov. 2026.
