Do You Still Need a Server With Cloud Dental Software? What Stays in the Office in 2026

The software rep's slide said "no more server." Then the office manager walked the floor with a notepad and counted: a computer under the sensor holder in every operatory, the pano's own PC, the CBCT workstation with a drive full of scans, two label printers, a signature pad, the firewall and the switch in the closet. One owner put it bluntly on a dentists' forum this year: "if you take xrays you will always need a physical server." Another answered: "Cloud is cool until your internet slows down."

This guide is for the owner who has picked, or is about to sign for, a cloud system and now has to write the hardware list. It shows what leaves and what stays, platform by platform from each vendor's own documentation, when CBCT keeps a small server in the building, and what each path costs over five years using only published list prices. Choosing the system itself is a separate question, covered in our guide to dental practice management software.

What leaves the office when the practice software moves to the cloud, and what stays?

The practice-management database and its server leave the office: the vendor hosts, patches and backs them up. Everything that touches a patient or a cable stays. Capture computers for sensors, cameras and CBCT, printers and signature pads, the firewall, switches and Wi-Fi, the internet circuit, sign-ins and the backup of anything still stored locally remain the practice's job.

A capture computer is the workstation a sensor, intraoral camera, scanner or CBCT unit plugs into; it runs the device driver and the software that takes the image. A hybrid office runs its practice software in the cloud and keeps one local machine, usually for imaging.

Checked against vendor pages on 1 November 2026: Dentrix System Requirements 2026 for the on-site column; Dentrix Ascend, Open Dental Cloud and Archy pages for the cloud column (sources below each platform).

The short version: the closet gets emptier, but the operatories do not. If you want help planning the office side, see our cloud setup for dental offices. Everything about the move itself, from readiness to cutover, is in our guide to what moving practice management to the cloud changes.

Platform by platform: what each vendor says still runs locally

Each cloud vendor publishes its own rules for what the office keeps. Dentrix Ascend uses a local acquisition agent for imaging, Open Dental Cloud says the local computers stay with the practice or its IT, and Archy hands large CBCT files to the scanner's own software. Read the vendor's page, not the brochure, before you buy hardware.

Vendor pages read 1 November 2026. Vendors change these pages without notice; ask for the current version in writing.

Dentrix Ascend

Henry Schein One's imaging page says Ascend images are "captured with a single click, securely stored in the cloud, and automatically linked to the patient record," and that "Ascend imaging supports 2D, 3D, CBCT, and CAD/CAM devices, with no extra fees or integrations" (Dentrix Ascend imaging, read 1 November 2026). Capture is still local. Ascend's help pages describe an acquisition agent on the capture computer and an offline mode "for both PC and Mac OS" that keeps acquiring when the internet drops and synchronizes later; the same page warns that exiting the agent means offline images are not detected (acquiring images in offline mode).

Ascend's system requirements list Windows 10 (64-bit) or 11, macOS 12 or later, 8 GB of memory minimum and 16 GB recommended, and the latest Chrome. The bandwidth line is the one to test against: 50 Mbps down and 10 Mbps up, "assuming that 10 logon IDs are being used at one time and at one location", so a busier front desk needs more. Document scanners need TWAIN drivers built on version 1.9 or later, and automatic document feeders are not supported, so check the front-desk scanner before go-live.

On 3D, Ascend's July 2022 release notes said the CBCT procedure "is not intended for specialty doctors such as Oral Surgeons, Orthodontists, and Implant Specialists" and that "the 3D volume image uploading feature only works on a Windows desktop computer" (release notes, 5 July 2022). Those notes are four years old; ask Henry Schein One what applies to your unit today.

Open Dental Cloud

Open Dental hosts the database and the images folder. Its differences page says "The A to Z Images (OpenDentImages) Folder is not stored locally," that imports come "from the local workstation instead," that "Video Capture is not available," that "Import Automatically is not available," and that "Signatures are supported only when using a Topaz Signature Pad" (Open Dental Cloud Differences, read 1 November 2026). On a server install, that same folder is "typically found on the C drive of the server" (A to Z folder manual).

The Open Dental Cloud page answers this article's question in one sentence: "The local computers that access the Open Dental Cloud are still fully managed by the practice or their IT." Its fit checklist wants 20 Mbps down, 10 up and latency under 30 ms, and lets a practice either keep separate imaging software that "doesn't need to be hosted" or have it hosted. For the workstation and bridge side of Open Dental, see our Open Dental support page.

Archy and other browser-native systems

Archy runs in a browser. Its imaging page says "Imaging is built into Archy," that "Every image uploads to the cloud," and that "Offline capture keeps x-rays coming through during an outage" with uploads "once the network is back" (Archy dental imaging, read 1 November 2026). Its CBCT answer is the important one for this guide: "Large CBCT and 3D files open through a bridge that launches native CBCT software; the files themselves live in that separate viewer, not in Archy's own storage." Schick sensors connect natively; other devices use TWAIN drivers. The FDA cleared Archy Dental Imaging under 510(k) K251880 on 21 November 2025. Offices on Archy can read how the workstations, sensors and network around it are looked after on our Archy IT support page.

For comparison: Dentrix on a server

The server-based list is longer because the database lives with you. In the April 2026 edition of its requirements, Henry Schein One asks for a Dentrix server with four or more cores at 2.4 GHz, 16 GB of memory ("Additional memory may be required for more than 10 workstations"), 60 GB free on SSD or NVMe, a 1 Gbps network and a Windows Server release from 2016 to 2025 (Dentrix System Requirements 2026). It also warns that wireless networks are used "at your own risk due to potential interference from X-ray machines." The Dentrix IT support page covers that environment.

Do CBCT and 3D scans still need a server in the building?

Often, yes: at least a small local machine with storage. On every platform in this guide, CBCT capture happens on a local acquisition computer. Whether the volumes then live on a small local server, a NAS or a vendor's cloud depends on the imaging software, upload speed, offline viewing and referral exports. The CBCT vendor's requirements win.

A NAS (network-attached storage) is a storage box on the office network that holds files without being a full server. For some hybrid offices it is enough; for imaging software that needs its own database, it is not.

When capture stays local

Capture is local on every platform in this guide. Carestream's CS 3D Imaging requirements (edition 01, February 2023) show why the CBCT computer is not an ordinary front-desk PC: the implant-planning module calls for 8 GB of memory, "Dedicated graphics card with 1 GB of memory supporting OpenGL v3.2", says "AMD and Intel graphics chips are not supported," and asks for a "1000 BaseT network bandwidth (1Gb/s)" connection. The same sheet says "Storage space depends on imaging device" and lists Windows Server 2012 to 2022 among supported systems, which tells you the software expects that it may be installed on a server (CS 3D Imaging requirements). Ask your CBCT vendor for the current edition before you buy.

Storage is where cloud plans meet imaging reality. Open Dental Cloud's Small package includes 20 GB of image storage and its Medium package 40 GB, with extra storage at $0.40 per GB, billed on the largest size recorded in the billing cycle (Open Dental Cloud, read 1 November 2026). For a server, Dentrix's own requirements estimate 40 GB "for the space that might be needed for patient images or patient records" on a dedicated server. A single office with years of 2D images can approach those figures before a single CBCT volume is counted, which is why many offices keep 3D files local.

When a small local server or NAS is the right call

Use this list with your CBCT and imaging vendors. Two or more ticks usually point to keeping a small local imaging store; none points to trying cloud-only imaging first. Our page on imaging PCs and small imaging servers covers the hardware side.

If you keep a local box, give it a support date like any server. Its operating system decides how long it receives security updates:

Dates as published on Microsoft's lifecycle pages for Windows Server 2016, 2019, 2022 and 2025, read 1 November 2026 (Pacific time). Dentrix's 2026 requirements give the same 2016 date, 1/12/2027.

Specialty offices meet this question harder, because 3D is daily work: see the orthodontic version of this decision and the endodontic software server-vs-cloud guide.

What does each path cost over five years: on-site server, cloud, or hybrid?

Over five years, the cloud path swaps a server purchase, its Windows license and its replacement for 60 monthly hosting fees plus a migration fee. The hybrid path pays the hosting and keeps a smaller imaging box. Only some vendors publish prices, so build the comparison from published list prices and written quotes, and leave nothing blank.

The five-year worksheet

Fill in every "quote" cell in writing, for the same 60 months, before you compare totals.

Microsoft lists Windows Server 2025 Standard at a suggested retail price of $1,176 for 16 cores and notes it "Requires Windows Server CAL" (Windows Server pricing, read 1 November 2026).

A worked example from published list prices only

Two vendors in this guide publish prices on their own pages. On Open Dental's fees page, support for one location with up to three providers is $199 a month for the first year, then a current reduced rate of $149; hosting is charged on top, because the page says cloud fees are "in addition to the Open Dental Software License and Support fees." Archy's pricing page lists its platform at $899 per month per location with unlimited users and providers, and a new-practice rate of $400 per month "until 400 patients or 1 year." Dentrix Ascend does not publish a price, so ask for a written quote.

For one location, up to three providers, over 60 months, those published prices add up like this (software fees only, read 1 November 2026):

Read the table as a starting line, not a verdict. The on-site column looks cheapest only until you add the server, its Windows license, its backup and the replacement it will need inside the period; the cloud columns look more expensive only until you remove those lines. The $149 rate is "the fee published on the day the office reaches the 13th month," so it can change, and Open Dental says "An official quote will be provided before signup." To decide whether to replace the server now, use the scorecard in our guide to deciding whether to replace the server now.

What keeps the office working when the internet or the vendor is down?

Three local pieces carry a cloud office through an outage: a second internet line that fails over on its own, capture software that saves images locally until the connection returns, and a printed schedule for the next day. If the vendor itself is down, only paper and those local images keep the day moving.

On the AWS outage of 20 October 2025, one owner wrote, "We use Vyne for claims and it is also currently down." Test the failover line before you need it. For the steps on the day, see what to do when the office internet is down; for vendor outages and data exit, see the outage section of our guide to moving practice management to the cloud.

Before you switch off the old server: a decommissioning checklist

Do not switch off the old server the day the cloud system goes live. First confirm nothing still points at it, that every old image opens in the new system, and that a read-only copy is kept for your record-retention period. Then wipe or destroy the drives and keep the certificate.

For step 6, NIST's media-sanitization guideline, SP 800-88 Rev. 2 (September 2025), defines sanitization as "a process that renders access to target data on the media infeasible for a given level of effort." Ask whoever removes the server which method they use and for a certificate. For step 7, our dental backup plan guide explains what to back up when only part of the office is local, and the restore-test checklist shows how to prove the copy works.

What to ask your IT provider about keeping a server with cloud software

Ask these before you sign the cloud contract, and get the answers in writing. They turn "no more server" into a hardware list with owners and dates.

How Legend Networking can help

Legend Networking has 22+ years in dental IT and has served over 3,500 practices since 2004. Legend supports the IT environment for the practice software Dentrix, Eaglesoft, Open Dental and Archy, and for the imaging systems DEXIS, Vatech, Carestream, Planmeca/Romexis and Dolphin Imaging, which is where the "what stays" list is usually decided. Onsite dispatch is by appointment across served dental markets, and support is remote-first nationwide.

The author, Ian Lynch, has 22 years in dental IT and oversees the NOC, onsite dispatch and client technology roadmaps. Legend holds a 4.8 rating from 173 Google reviews.