Orthodontic Practice Technology: The IT Guide for Owners and Office Managers
It is a full adjustment day. Every chair in the open bay is booked, two scans sit in the upload queue, imaging is slow at the far end of the row, and the front desk's schedule freezes each time the internet blips. If you are one of the practice owners and office managers who gets that call, this is the IT side of orthodontic practice technology, written for you rather than for the clinical team.
If you are looking for a support provider rather than a guide, start with our dental IT support page. This guide gives you a stack map with a who-to-call matrix, a network plan for the open bay, a storage worksheet, the upgrade dates that already affect ortho software, a vendor inventory for patient data and a 15-question scorecard for any IT company. It comes from Ian Lynch, who has 22 years in dental IT and oversees the NOC, onsite dispatch and client technology roadmaps.
In this guide
- What technology does an orthodontic practice need?
- Your stack map: what runs where, and who to call
- Server or cloud: what your ortho software asks of IT
- How should an orthodontic office network be built?
- Workstations and servers: the minimums vendors publish
- How much data storage (GB/TB) does an orthodontic practice need for imaging and records?
- Scanners, printers and aligner portals
- The orthodontic upgrade calendar: what is already overdue
- Security: the vendors that hold your patients' data
- Questions to ask an IT company before you hire it for an orthodontic practice
- Opening, adding or buying an office: where to start
- Orthodontic offices Legend has set up
- What does IT cost for an orthodontic practice?
- The bottom line
- Frequently asked questions
- The bottom line
What technology does an orthodontic practice need?
From the owner's side, an orthodontic practice needs the same layers as any dental office, arranged differently: one practice system for scheduling, contracts and payments; an imaging archive built around records; scanners that upload over Wi-Fi; a network sized for an open bay; many cloud apps; and backups that keep years of records safe.
The list is familiar. What changes is the shape of the work, and that shape decides where IT time and money go. The table compares the two kinds of office from the IT side only; clinical choices belong to the doctor.
| Area | General dental office | Orthodontic office | What it means for IT |
|---|---|---|---|
| Patient flow | Closed operatories, one patient per room | An open bay with chairs in a row and many short visits | Wi-Fi and workstations serve many devices in one open space |
| Imaging | Bitewings, periapicals, some panoramic images | Ceph and pano at records, photo series at each stage, CBCT for selected cases | A larger image archive that grows with every new start |
| Devices | One intraoral scanner, if any | One or more scanners, sometimes an in-office 3D printer | Scanner Wi-Fi and upload speed become daily issues |
| Data life | Visits and insurance claims | Multi-year treatment contracts and payment plans; many patients are minors | Long retention, financial data in the practice system and careful access control |
| Locations | Usually one office | Some practices add satellite offices | Each office needs a plan for the practice system, imaging and internet |
| Apps | Practice system, imaging, email | Practice system plus texting, financing, remote monitoring and aligner portals | More vendors holding patient data and more logins to manage |
If your office combines pediatric dentistry and orthodontics, our page on IT for pediatric dental practices covers the pediatric side.
Next step: list the six layers for your own office in the stack map below.
Your stack map: what runs where, and who to call
A stack map is a one-page table of every system in the office: what it is, where it runs, what IT has to keep working and who you call when it stops. Build it once, keep it at the front desk and in your IT provider's file, and update it whenever you add a system, a vendor or an office.
Start with the reference version below. It names systems an orthodontic office may run; yours will be a subset.
| Layer | Systems an ortho office may run | Where it lives | What IT must keep working | Who to call first |
|---|---|---|---|---|
| Practice management | Dolphin Management, OrthoTrac (Carestream Dental's practice software), Cloud 9, Ortho2 Edge Cloud, topsOrtho, Greyfinch | A server in the office, a vendor cloud, or a hosted remote-desktop session | Server, SQL Server database, workstations, internet line, user accounts | The vendor for application errors; IT for server, network and computer problems |
| Imaging | Dolphin Imaging, Carestream imaging (CS Imaging), Planmeca, a CBCT viewer | A server share plus capture workstations | Storage, capture drivers, workstation graphics, backups | IT first; the imaging vendor for software faults |
| Intraoral scanners | iTero, 3Shape TRIOS, Medit | The scanner or its cart, uploading to the maker's cloud | Wi-Fi coverage, upload bandwidth, firewall rules | IT for Wi-Fi and internet; the scanner maker for the device (see the scanner section below) |
| Printers and 3D printers | Laser and label printers, a 3D printer such as SprintRay | The office network | Drivers, network discovery, a print server for satellite offices | IT |
| Patient communication and financing | Texting and reminders, OrthoFi or another financing app, remote monitoring | Vendor clouds | Logins, multi-factor authentication, links to the practice system | The app vendor; IT for logins and integrations |
| Network and internet | Firewall, switches, Wi-Fi access points, one or two internet lines | The network closet | Design, separate networks, monitoring, failover | IT; the internet provider for a line outage |
| Phones | VoIP or carrier phone service | A cloud service or an on-site system | The voice network and quality-of-service settings | The phone provider; IT for the network side |
| Backup, email and accounts | A backup device or service, Microsoft 365 or another email service | A local device plus an offsite copy; the cloud | Backup jobs, restore tests, accounts, multi-factor authentication | IT |
Now fill in your own. One row per system is enough; the point is that every row has a name in the last two columns.
| Layer | Product and version | Where it lives | Vendor support page | Who calls the vendor | Last reviewed |
|---|---|---|---|---|---|
| Practice management | ____ | ____ | ____ | ____ | ____ |
| Imaging | ____ | ____ | ____ | ____ | ____ |
| Scanners | ____ | ____ | ____ | ____ | ____ |
| Printers | ____ | ____ | ____ | ____ | ____ |
| Apps | ____ | ____ | ____ | ____ | ____ |
| Network | ____ | ____ | ____ | ____ | ____ |
| Phones | ____ | ____ | ____ | ____ | ____ |
| Backup and email | ____ | ____ | ____ | ____ | ____ |
Where Legend fits: Legend supports the IT environment for DEXIS, Vatech, Carestream, Planmeca/Romexis and Dolphin Imaging. Practice systems such as OrthoTrac, Cloud 9, Edge or Greyfinch are systems your practice runs: the vendor supports the application, and the computers, network, server, backups and accounts around it are IT's job. Legend's support model: in-house engineers with no outsourced first-level triage, 24/7 monitoring, and a staffed 24/7 helpdesk at 1-800-794-1588.
Who do you call when something breaks?
Call the software vendor when one application shows the same error on every computer and the network is fine. Call IT when several systems fail at once, when only one computer or the Wi-Fi is affected, or when you cannot tell. Before calling either, write down the time, the computer name, the exact message and whether the internet was working.
| Symptom | Likely layer | Call first | Have ready |
|---|---|---|---|
| The practice system will not open on any computer | Server, database or vendor cloud | IT, then the vendor once the server checks out | When it started, the error text, whether imaging also fails |
| One chair's computer is slow; the others are fine | That workstation | IT | Computer name, what was open, any recent update |
| Scans are stuck in the upload queue | Scanner Wi-Fi or internet upload | IT for Wi-Fi and internet; the scanner maker for the device | Scanner name, signal level shown, time of the last good upload |
| The cloud schedule freezes or logs everyone out | Internet line or firewall | IT; the internet provider if the line is down | A speed test result and which offices are affected |
| Calls break up while photos or backups upload | Network quality-of-service | IT, then the phone provider | Time of day and what was uploading |
| New images do not appear in the patient chart | Imaging bridge or capture driver | IT first, the imaging vendor second | Capture station name and the patient chart number |
| A printer or 3D printer cannot be found | Network discovery | IT | Printer name and whether it was moved or restarted |
| Staff are locked out of email or a vendor portal | Accounts and multi-factor authentication | IT for Microsoft 365; the vendor for its own portal | Username and which phone holds the authenticator |
Gaps in your stack map? A Free Dental IT Assessment gives you written findings and prioritized recommendations on your computers, software, network security, backups and performance.
Next step: if your practice system lives on a server, read the next section before the next hardware purchase.
Server or cloud: what your ortho software asks of IT
Server-based systems need a Windows server, a SQL Server database and a domain network. Browser-cloud systems need enough internet for every computer and a dependable line at every office. Hosted remote-desktop systems need a steady connection plus a local computer for image capture. Which model you run decides what your IT has to look after.
The vendors say so in their own documents. Dolphin's system requirements (rev. 06/25) state that "When a Server operating system is used, a Domain is required," and recommend Windows Server 2022 Standard with SQL Server 2022 Standard. Carestream "recommends using a dedicated server to run OrthoTrac." Cloud 9 works the other way: Planet DDS says "Each office requires its own dedicated connection to the Internet," wants the office IP static during office hours, and gives 1 Mb/s download and 0.5 Mb/s upload per computer as its minimum. Dolphin Cloud runs the software in a hosted session, but a capture workstation may still run Dolphin Imaging locally, which Dolphin says is "sometimes necessary for non-TWAIN compliant X-ray machines or CBCT acquisition."
SQL Server Express also has limits your vendor documents; Dolphin notes it dedicates only 1 GB of RAM and one processor to the database. The full comparison of deployments, bandwidth and database editions is in our guide to orthodontic practice management software: cloud vs server. For general dentistry systems, see our practice management software comparison and our article on cloud dental software (general dentistry).
Next step: write the deployment model (server, cloud or hosted) into the first row of your stack map.
How should an orthodontic office network be built?
Build it as separate networks on one set of hardware: a wired clinical network for the server and workstations, scanner Wi-Fi that meets each scanner maker's published spec, an isolated guest network for parents, and their own segments for phones and for cameras. Then size the internet upload for scans, cloud software and backups together, not one at a time.
An open bay is a single large room full of devices, so the usual small-office habit of one Wi-Fi network for everything breaks down quickly. This table is the plan to hand to whoever designs or audits the network.
| Network or Wi-Fi name | What is on it | Rule | Why |
|---|---|---|---|
| Clinical (wired) | Server, practice-system and imaging workstations, capture stations | Wired wherever possible; Dolphin requires at least Fast Ethernet (100 Mbps) and recommends 1 Gigabit | Database and imaging traffic is steady and heavy |
| Scanner Wi-Fi | iTero, TRIOS, Medit and other scanners | WPA2 with a password; iTero wants a signal that is "Excellent or at least Good"; TRIOS Share needs 5 GHz 802.11ac and a signal stronger than -60 dBm | Scans upload to the maker's cloud over Wi-Fi |
| Guest and parent Wi-Fi | Phones and tablets of patients and parents | Isolated from clinical devices; its own password, never the clinical one | Keeps unknown devices away from patient data and off the scanner network |
| Voice | VoIP phones | A separate segment with quality-of-service rules | Large uploads should not break up calls |
| Cameras and door access | Security cameras, video doorbells, door controllers | A separate segment with limited upload | Dolphin warns that one high-resolution camera can use nearly all upload bandwidth |
| Printers and 3D printers | Office, label and 3D printers | On the segment of the computers that use them, or behind a print server | Discovery fails across badly planned segments |
Three vendor lines are worth taping to the network closet door. Align's iTero Element 5D manual asks for an upload speed of "at least 1Mbps per scanner" and notes that "any additional devices connected to the internet in parallel to the scanner may affect the scanner's performance." The same manual carries a safety warning: "Never connect the LAN cable to the iTero Element 5D, in order to prevent electrical shock." Align's 2024 iTero Lumina manual carries the same warning. And for open-bay coverage, the iTero Element 2 and Flex manual notes that "Each barrier can reduce your adapter's range by 1-3 meters (3-9 feet)," which is why access points belong above the chair rows rather than in a back office. For TRIOS, 3Shape's TRIOS Share network requirements say TRIOS Share works on the 5 GHz band only, needs a signal stronger than -60 dBm at the scanner, and that all TRIOS scanners work with WPA2 Personal security (newer models and software add WPA3 Personal).
Phones and cameras need the same planning. Planet DDS advises that offices using VoIP "should consider setting up network-based quality of service controls," and Dolphin's Cloud section warns: "A single Ring Video Camera in highest resolution can consume nearly all the upload bandwidth from a Practice without them even realizing it." Both Dolphin and Planet DDS suggest a second internet connection; Planet DDS "recommends, but does not require" one and says the two should not use the same connection type.
Open-bay network checklist
- Access points mounted above the chair rows, not in a closet or back office
- Wi-Fi signal measured at every chair where a scanner is used
- Guest Wi-Fi isolated from clinical devices, with its own password
- Phones on their own segment with quality-of-service rules
- Cameras and door access on their own segment, with upload limited
- A second internet line from a different provider, with automatic failover in the firewall
- Large backups and updates scheduled outside scan hours
- A current network map kept with the stack map
If your phones still run over copper lines, see our page on dental office phone systems and VoIP. For design and cabling, see secure dental office network design and our guide to dental office network setup.
Next step: compare your current Wi-Fi names with the table and note any network that mixes guests, scanners and clinical computers.
Workstations and servers: the minimums vendors publish
Buy to the vendor's recommended column, not the minimum. Dolphin and OrthoTrac both publish minimum and recommended specifications, and their minimums include server and database versions that Microsoft no longer supports or soon won't. Workstations should run Windows 11 Pro, and scanner computers should come from the scanner maker's approved list.
The OrthoTrac v15.7 requirements list Windows 11 Professional for workstations and note that "Windows 10 reached end-of-life on October 14, 2025." Dolphin recommends 16 GB of RAM or more for the server and says an "SSD RAID controller disk [is] highly recommended." Our workstations and servers page covers buying and replacement; the server and database detail for each ortho system is in the cloud-vs-server guide linked above.
Next step: add the Windows version of every computer to your stack map.
How much data storage (GB/TB) does an orthodontic practice need for imaging and records?
Not floor space: this is the server and backup storage for ceph, pano, photo series, intraoral scans and any CBCT. Measure it from your own imaging archive: add up the folders of ten recent records patients, divide by ten, multiply by new starts a year, then add progress records, CBCT and backup copies.
Published averages do not help much here, because file sizes depend on your cameras, settings and imaging software. Your own archive is the best evidence you have. The formula is:
Annual imaging growth (GB) = new starts per year × average records set per patient (GB) + progress and retention records + CBCT studies per year × size per study.
Storage worksheet in six steps
- 1Pick ten recent records patientsStep 1Choose ten patients whose initial records were taken in the last few months, so the sample reflects your current cameras and settings.
- 2Measure their foldersStep 2In the imaging archive, right-click each patient's image folder, choose Properties and note the size; your IT provider can export the same figures from the server.
- 3Find the averageStep 3Add the ten sizes and divide by ten. That is your average records set.
- 4Multiply by new startsStep 4Multiply the average by the number of new starts you expect in a year.
- 5Add progress, final records and CBCTStep 5Measure progress and final records the same way, then add each CBCT study you expect at its exported size.
- 6Multiply for backup copiesStep 6Multiply the yearly total by the number of copies you keep, such as the server, a local backup and an offsite copy.
Here is a worked example. The inputs are round, invented numbers chosen to show the arithmetic; they are not a benchmark for any practice. Measure your own.
| Step | Example input (invented) | Result |
|---|---|---|
| Average initial records set | 300 MB per patient | — |
| New starts per year | 400 | 400 × 300 MB = 120 GB |
| Progress and final records | 200 MB for each of 350 finishing patients | 70 GB |
| CBCT studies | 20 a year at 400 MB each | 8 GB |
| New imaging per year | — | about 198 GB |
| Copies kept (server, local backup, offsite) | 3 (a planning assumption, not a rule) | about 594 GB of new storage a year |
For the CBCT line, the BeamReaders knowledge base lists typical DICOM exports of 50–150 MB for a small field of view, 150–400 MB for a medium one and 400 MB–1 GB for a large one. CBCT is selective in orthodontics rather than routine: a 2019 review in Dentistry Journal notes that panoramic and cephalometric radiographs are sufficient for most initial, progress and final records. That decision is the doctor's; your worksheet simply counts the studies you actually take.
Photo settings matter too. Dolphin recommends saving photos at about 3 megapixels (2000 × 1500), which it says "will dramatically reduce the resultant file sizes," and notes that many cameras ship set far higher. Check camera settings before you buy more storage.
How long you keep records is set by your state; check with your dental board or compliance adviser before deleting anything.
Storage is only half the job; the copies have to restore. Dolphin's requirements say: "You are responsible for making proper backups of your Dolphin data, which includes database, image files, documents, letter templates, etc." and "Dolphin recommends implementing a proper backup protocol including offsite data backups." Carestream recommends a nightly OrthoTrac backup and running "Prepare Backup" (or a scheduled Orthobac.exe task) first, because SQL Server may hold the database files open during a full system backup. Test a restore of one patient's images and the database every quarter. Legend's backup add-on is listed as: Backup protection from $39.99 per month (storage-dependent).
For the full routine, see our dental backup and disaster recovery checklist and our overview of dental backup solutions. Dolphin users can also read our page on Dolphin Imaging IT support.
Next step: run the worksheet this month and write the yearly growth figure next to the imaging row of your stack map.
Scanners, printers and aligner portals
Intraoral scanners upload each scan over Wi-Fi to the maker's cloud, so they depend on signal and upload speed. Older TRIOS carts also hit a Windows 11 limit. Aligner portals such as the Invisalign Doctor Site and ClinCheck are browser workloads that need a current browser and steady internet at every chair that uses them.
On the cart question, 3Shape's Windows 11 FAQ says TRIOS MOVE and TRIOS 3 carts "use processors that are not supported by Microsoft for Windows 11 and therefore cannot be upgraded." First-generation TRIOS MOVE+ units, shipping since April 2019, can be upgraded, and units shipping since September 2023 come with Windows 11. Printers and 3D printers need to sit on the network segment of the computers that send them jobs. Scanner bandwidth, Wi-Fi settings and what to check when an upload fails are covered in our guide to intraoral scanner IT requirements.
Next step: add every scanner's model and cart generation to the stack map.
The orthodontic upgrade calendar: what is already overdue
As of 26 October 2026, Windows 10, Office 2016, 2019 and 2021, SQL Server 2016 and Windows 11 version 24H2 are past Microsoft's end of support, and Windows Server 2016 ends on 12 January 2027, 78 days away. Ortho software minimums still list several of these versions, so check what your office runs now.
| Product | Support ends | Status on 26 October 2026 | Why an ortho office cares |
|---|---|---|---|
| Windows 10 (all editions) | 14 October 2025 | Ended | OrthoTrac v15.7 lists Windows 11 Professional for workstations |
| Windows 11 Home/Pro 23H2 | 11 November 2025 | Ended | Update chair-side and front-desk computers |
| Windows 11 Home/Pro 24H2 | 13 October 2026 | Ended | Move to version 25H2 or 26H2 |
| Windows 11 Home/Pro 25H2 | 12 October 2027 | Supported | Current target for most workstations |
| Windows 11 Home/Pro 26H2 | 9 October 2028 | Supported | Newest release |
| Microsoft Office 2016 and 2019 | 14 October 2025 | Ended | OrthoTrac's letter integration needs 32-bit desktop Office; check which supported version your software lists |
| Microsoft Office 2021 and Office LTSC 2021 | 13 October 2026 | Ended | Not a replacement for 2016 or 2019; a version your software lists can still be out of Microsoft support |
| SQL Server 2016 (including Express) | 14 July 2026 | Ended; paid Extended Security Updates year 1 runs to 13 July 2027 | Dolphin's and OrthoTrac's minimum database is SQL Server 2016 |
| Windows Server 2016 | 12 January 2027 | 78 days left | The minimum server version for Dolphin and OrthoTrac |
| Windows Server 2019 | 9 January 2029 | Supported | — |
| SQL Server 2019 | 8 January 2030 | Supported | — |
| TRIOS MOVE and TRIOS 3 carts | Not compatible with Windows 11 | Left on Windows 10 | Plan the cart replacement with 3Shape |
Microsoft's lifecycle pages show each end time in the early hours of the following day, so the dates here are the last full day of support. Check them yourself: Windows Server 2016, SQL Server 2016, Windows 11 Home and Pro and Office 2016, 2019 and 2021.
The reason this matters more in orthodontics: Dolphin's minimum is "Microsoft SQL Server 2016 (SP3) Express" on Windows Server 2016 Standard, and OrthoTrac v15.7's minimum is Windows Server 2016 Standard with SQL Server 2016 Express. An office built to the minimum column is already on an unsupported database and has weeks left on its server.
What to do this quarter
- Ask your IT provider for a list of every server, its Windows version and its SQL Server version
- Ask your practice-software vendor which server and SQL Server versions its current release supports
- Plan the Windows Server 2016 replacement or cloud move before 12 January 2027
- Decide on SQL Server 2016: upgrade, paid Extended Security Updates as a bridge, or the vendor's cloud
- Update every Windows 11 computer still on version 24H2 or earlier
- Check TRIOS cart models and the Office version on front-desk computers
For the wider picture, read our guides to Windows 10 end of life for dental practices and dental server replacement vs cloud migration.
Next step: put the end date next to every product in your stack map.
Security: the vendors that hold your patients' data
Many vendors hold an orthodontic office's patient data: the practice system, imaging cloud, scanner cloud, texting, financing, remote monitoring and analytics apps. Keep a list of each one, with who the admin is, whether multi-factor authentication is on and whether a business associate agreement is on file, and review the list at least once a year.
Orthodontic data has a particular shape. Many patients are minors, treatment contracts and payment plans run for the whole treatment, and the work depends on more cloud vendors than a typical general office uses. Each vendor login is a door into patient records.
Vendors are part of the risk. In March 2025, HIPAA Journal reported that OrthoMinds, an Alpharetta, Georgia-based provider of orthodontic practice management software, had improperly secured databases that "could be accessed freely over the Internet, with no access controls in place." The forensic investigation covered November 17 to November 27, 2024. The breach was reported to the HHS Office for Civil Rights as involving at least 501 individuals, while a security researcher claimed the data covered at least 200,000 patients.
Use this table as your vendor inventory. Fill one row per vendor or app.
| Vendor or system | Holds patient data? | BAA on file? | MFA on? | Who is the admin? | Last reviewed |
|---|---|---|---|---|---|
| Practice management system | ____ | ____ | ____ | ____ | ____ |
| Imaging software and imaging cloud | ____ | ____ | ____ | ____ | ____ |
| Scanner clouds (iTero, TRIOS, Medit) | ____ | ____ | ____ | ____ | ____ |
| Texting and reminders | ____ | ____ | ____ | ____ | ____ |
| Financing and payments | ____ | ____ | ____ | ____ | ____ |
| Remote monitoring | ____ | ____ | ____ | ____ | ____ |
| Email and Microsoft 365 | ____ | ____ | ____ | ____ | ____ |
| Backup service | ____ | ____ | ____ | ____ | ____ |
| IT provider | ____ | ____ | ____ | ____ | ____ |
Which vendors need a business associate agreement is a question for your compliance adviser; the inventory tells you who to ask about.
Six checks for every vendor login
- Multi-factor authentication turned on for every account that can see patient data
- A named admin for each vendor, and a second person who knows how to reach them
- Departing staff removed from every vendor portal on their last day
- Shared logins replaced with named accounts where the vendor allows it
- Vendor list and network map reviewed at least once a year
- Patient images and scans sent through the vendor's portal or another secure channel, not ordinary email
The list may soon be more than good practice. In January 2025, HHS published a proposed change to the HIPAA Security Rule that would require a written technology asset inventory and a network map, reviewed at least once every 12 months. As of 26 October 2026, it is still a proposed rule; the Federal Register lists no final rule. Our article on HIPAA Security Rule updates for dental practices tracks it.
For email, see email security for dental offices. For the threats themselves, read dental cybersecurity: ransomware and phishing and dental ransomware recovery. Our HIPAA technical safeguards for dental practices page covers the controls side.
Next step: fill in the first three rows of the vendor inventory this week.
Questions to ask an IT company before you hire it for an orthodontic practice
Ask questions that only someone who has worked in an orthodontic office can answer well: which ortho systems they know, how they handle scanners, SQL Server and satellites, where your backups are and what the price leaves out. Score one point for each good answer. Fewer than 10 out of 15 tells you where the gaps are.
| No. | Question | A good answer | A red flag |
|---|---|---|---|
| 1 | Which ortho practice-management and imaging systems have you worked with, and what do you do for each? | Names systems and says what IT does versus the vendor | "We support everything" |
| 2 | Who calls the software vendor when it fails, you or us? | A clear rule for who calls and when | "Call them yourselves" for every issue |
| 3 | What SQL Server edition and version are we on, and is it right for our workstation count? | Knows, or finds out the same week | Does not know what SQL Server is used for |
| 4 | When does our server operating system reach end of support? | A date and a plan | "It still works" |
| 5 | When did you last test a restore of our imaging archive, and how long did it take? | A date and a duration | "Backups run every night" with no restore test |
| 6 | Where are our backups, and how many copies are offsite? | Locations and copy count | One copy in the same room as the server |
| 7 | Is guest Wi-Fi separated from the clinical network? | Yes, and how | One network for everyone |
| 8 | Does each scanner meet its maker's Wi-Fi and upload spec? | Measured at the chairs | Never measured |
| 9 | Do our phones have their own segment or quality-of-service rules? | Yes, and it was tested under upload load | Phones share everything |
| 10 | Do we have a second internet line, and does it fail over automatically? | Yes, from a different provider | One line, or manual switching |
| 11 | Which of our vendors hold patient data, and is a BAA on file for each? | A written vendor list | No list |
| 12 | Is multi-factor authentication on for email, the practice system and every cloud vendor? | Yes, with exceptions written down | Only on email, or not at all |
| 13 | Who holds admin passwords, and what happens when someone leaves? | A named process and a password manager | Passwords on sticky notes or in one person's head |
| 14 | How would you connect a satellite office for our practice system? | An answer specific to your system's requirements | One design for every system |
| 15 | What is in the monthly price, and what is quoted separately? | A written list of both | Vague answers until the first invoice |
Scored under 10? That is what the Free Dental IT Assessment is for.
For general contract questions that apply to any dental office, see our 20 questions to ask before signing a dental IT contract.
Next step: send these 15 questions to your current provider and any provider you are considering.
Opening, adding or buying an office: where to start
Start with the guide that matches the project. Opening a new orthodontic office, adding a satellite, buying a practice and changing practice software each have their own order of work, and each is covered in its own guide so this one can stay focused on the office you already run.
- Opening a new office: our orthodontic office technology checklist covers the ortho-specific build-out, and our dental startup IT page covers the rest of the opening plan.
- Adding a satellite or buying a practice: read our guide to orthodontic satellite office IT, which covers connecting each practice system and checking an acquired office.
- Changing practice software: start with the cloud-vs-server guide linked in the server section above.
- Ten or more offices: see DSO IT support.
If you practise in a market we have written about, our specialty practice IT guide for Dallas is one example of the local view.
Orthodontic offices Legend has set up
Two recent projects show the kind of work involved. At the third Luv Braces location in Hutto, Texas, Legend built the network and installed workstations, imaging and practice management software, audio/video and surveillance. At the future home of East Texas Orthodontics in Canton, Texas, Legend was on site installing low-voltage cabling and network infrastructure ahead of the technology the practice will use.
What does IT cost for an orthodontic practice?
Legend's published price line for monthly IT support reads: Starting at $360 per month. Hardware procurement, major cabling projects and software licensing are quoted separately. Plans and what they cover are on our dental IT support page, and our dental IT support cost guide explains what drives the price for any dental office.
The bottom line
An orthodontic office runs on more systems, more vendors and more images than its size suggests. Four worksheets keep it under control: the stack map with its who-to-call matrix, the open-bay network table, the storage worksheet and the vendor inventory. The upgrade calendar tells you what to fix first, and the 15 questions tell you whether your IT provider can help.
The facts below are Legend Networking's own:
- Practices: Served over 3,500 practices since 2004
- Experience: 22+ years in dental IT (since 2004)
- Engineering team: In-house engineers; no outsourced first-level triage
- Monitoring and helpdesk: 24/7 monitoring, and a staffed 24/7 helpdesk at 1-800-794-1588
Frequently asked questions
What technology does an orthodontic practice need, and what do orthodontists use?
From the IT side, an orthodontic practice runs six layers: practice management software, imaging (ceph, pano, photo series and selective CBCT), intraoral scanners, a network with separate clinical, guest and voice segments, patient communication and financing apps, and backup and security. Each layer lives on a server, in a cloud or on a device, and each needs a named person to call when it fails.
How much data storage does an orthodontic practice need for imaging and records?
Measure it rather than guess. Add up the image folders of ten recent records patients, divide by ten and multiply by your yearly new starts. Add progress and final records, plus any CBCT studies, which typically export at about 50 MB to 1 GB each depending on field of view. Then multiply the total by the number of backup copies you keep.
SQL Server 2016 is out of support. What should we do?
Microsoft's extended support for SQL Server 2016 ended on 14 July 2026. First ask your practice-software vendor which SQL Server versions its current release supports. Then choose between upgrading the database, buying Microsoft's paid Extended Security Updates as a short bridge, or moving to the vendor's cloud. Plan it together with any Windows Server 2016 replacement.
When does Windows Server 2016 support end, and does it matter for Dolphin or OrthoTrac?
Microsoft's extended support for Windows Server 2016 ends on 12 January 2027. It matters because Windows Server 2016 is the minimum server version in both Dolphin's and OrthoTrac's published requirements, and both list Windows Server 2022 as recommended. If your server runs 2016, plan the replacement or a move to the cloud now rather than in January.
Should guest Wi-Fi for parents be separate from the clinical network?
Yes. Parents' and patients' phones are unknown devices, so they belong on an isolated guest network with its own password that cannot reach the server, workstations, scanners or printers. Keeping guests separate also stops their streaming from competing with scanner uploads on the clinical Wi-Fi. Change the guest password on a schedule and never share the clinical one.
When something stops working, do we call the software vendor or IT?
Call the vendor when one application shows the same error on every computer and the network is fine. Call IT when several systems fail together, when only one computer or the Wi-Fi is affected, or when you cannot tell. Note the time, the computer name, the exact message and whether the internet was working before you call.
Can our practice-software vendor handle our IT, or do we need an IT company?
Software vendors support their application: installs, updates, errors and data questions. Your network, firewall, Wi-Fi, workstations, server hardware, backups, email and staff accounts sit outside that, with an IT provider or an in-house IT person. In practice an orthodontic office needs both, plus a written list of who handles which problem.
The bottom line
If your stack map has blank rows, your server is on Windows Server 2016 or nobody can say where the imaging backups are, you are welcome to ask for a Free Dental IT Assessment. You get written findings and prioritized recommendations on your computers, software, network security, backups and performance. Or call 1-800-794-1588.