Introduction
If you are still running your dental practice on a server in your closet, you are losing money.
In 2026, the dental industry has officially moved to the cloud. The days of expensive IT guys and nightly backups are over. Modern software now handles AI Scheduling, Two-Way Texting, and Automated Insurance Verification automatically.
But with legacy giants like Dentrix and up-and-comers like Curve, which one should you choose?
We reviewed the top dental practice management systems (PMS) to help you modernize your office.
🏆 Summary: The Top 3 Systems for 2026
| Software | Best For… | Type | Rating |
| Open Dental | Best Overall (Value & Customization) | Server/Hybrid | ⭐⭐⭐⭐⭐ |
| Curve Dental | Best Cloud (Multi-Location) | 100% Cloud | ⭐⭐⭐⭐⭐ |
| Dentrix Ascend | Best for Traditionalists | Cloud | ⭐⭐⭐⭐ |
1. Open Dental (The People’s Champion)
Open Dental is the “cult favorite” among private practice dentists. It is open-source, affordable, and incredibly powerful—if you know how to use it.
Why it wins:
- Total Control: Unlike other systems that lock up your data, Open Dental gives you full access to your SQL database. This allows for unlimited custom reports.
- Cost: It is significantly cheaper than the corporate options.
- Integrations: Because it is “Open,” it integrates with almost every third-party tool (texting, billing, imaging) on the market.
The Catch: It is traditionally server-based (on-premise). However, in 2026, many hosting providers allow you to run it in the cloud.
- Verdict: The best choice for the solo owner-doc who wants to save money.
2. Curve Dental (The Modern Cloud Choice)
If you want to access your schedule from your iPhone while on a golf course, you need Curve Dental. It was built for the cloud from day one.
Why it wins:
- No Server Needed: You can throw that dusty server in the trash. All you need is a Chrome browser.
- Cybersecurity: They handle all the backups and security for you, reducing your HIPAA liability.
- Design: The interface is beautiful and modern. Training new front-desk staff takes hours, not weeks.
The Catch: It is a subscription model, so the monthly cost is higher than owning Open Dental outright.
- Verdict: The #1 choice for modern practices and multi-location groups (DSOs).
3. Dentrix Ascend (The Incumbent)
Dentrix (by Henry Schein) is the 800-pound gorilla of dentistry. Dentrix Ascend is their answer to the cloud.
Why it wins:
- Familiarity: If you hire a hygienist or office manager, there is a 90% chance they already know how to use Dentrix.
- Imaging: It has best-in-class integration with X-ray sensors and intraoral cameras (especially if you use Dexis).
- Support: Being owned by Henry Schein means you have massive corporate support behind you.
The Catch: It can be expensive, and some users find it less “agile” than startups like Curve.
- Verdict: The safe bet for large, established practices.
4. The “Add-On” Stack (Vital for 2026)
No PMS is complete without the right add-ons. In 2026, you need:
- Communication: Weave or Solutionreach. These tools sync with your PMS to send automated appointment reminders and “Review Requests” via text.
- Billing: Pearlah or Kleer. Use these to run your own “In-House Membership Plan” (a huge trend in 2026 to bypass insurance).
Conclusion: Which One Fits Your Practice?
- Choose Open Dental if: You are a DIY owner who wants powerful reporting and low fees.
- Choose Curve Dental if: You want a hassle-free, 100% cloud experience with zero IT headaches.
- Choose Dentrix Ascend if: You want the industry standard that your staff already knows.
Don’t forget the taxes:
Did you know you can rent your house to your practice for 14 days tax-free?
👉 Read Next: The Dentist’s Tax Guide (The Augusta Rule & Section 179)
