IT support for Dentrix, Eaglesoft and dental imaging software

Who supports Dentrix, Eaglesoft and dental imaging software in Dallas?

I do. I am Anthony Omini, the owner of Cross River Tech, and supporting the software a dental office runs on is the everyday work of my dental practice IT. That means Dentrix and Dentrix Ascend, Eaglesoft, Open Dental and the imaging systems that connect to them, Dexis, Schick and Sidexis, Carestream, Planmeca and others, in general terms, plus the server, the network, the workstations in every operatory and the backups underneath all of it.

Here is the honest shape of it. The practice management vendor supports its own product: a bug in the ledger, a feature that does not do what the manual says, a database repair that needs their tools. Everything the product depends on is IT: the Windows server it runs on, the database engine, the network between the server and twelve workstations, the sensor drivers, the printer that the treatment plan goes to, the backup, the user permissions and the update that was installed on a Tuesday afternoon between patients. When a dentist in Dallas says "Dentrix is slow" or "Eaglesoft keeps crashing in room three", the cause is in the second list far more often than the first, and that is the part I fix.

I do this remotely for most problems, which is why an office in Plano or Fort Worth gets the same help as one in North Dallas, and onsite by appointment when a sensor, a switch or a server needs hands on it. If something is broken right now, contact me or call (214) 612-7080. If you are choosing an IT provider and want to know whether I actually understand this software, the rest of this article is the answer.

What does supporting practice management software actually mean?

Every IT company's website says it supports dental software. Here is a table of who does what, so you can hold any provider, including me, to it.

The part of this table that matters most is the second column being mostly "no" or "rarely". The vendor's help desk is good at the product and not responsible for your office. The practice needs an IT person who knows enough about the product to tell which column a problem belongs in, and who will pick up the phone to the vendor on your behalf instead of telling you to call them. That is the difference between a general IT company and one that understands dental software.

Dentrix: what breaks and what I handle

Dentrix is the most common practice management system I see in Dallas offices. The traditional version runs on a Windows server in the office with a database engine underneath, and every workstation connects to it over the network. That architecture is reliable when it is set up right and fragile when it is not, and most of the "Dentrix problems" I am called about fall into a few groups.

• Server health. Dentrix is only as fast as the server's disk and memory and the database maintenance that should run on a schedule. An office that has grown from four operatories to eight on the same server it bought years ago will feel it in every screen.
• Workstation installs and updates. Every workstation runs a client that has to match the server version. Updates need to be applied everywhere, outside patient hours, after a verified backup. I schedule them, I take the backup, and I am the one who rolls it back if the update does not behave.
• Add-on services. Electronic claims, patient communication, e-prescribing and similar modules each depend on internet access, firewall rules and correct configuration, and each one has a way to stop working quietly.
• Permissions and user accounts. A hygienist who cannot open the chart, an office manager who suddenly has more rights than the dentist, or a departed employee whose login still works. I manage the Windows and Dentrix user lists together.
• Dentrix Ascend, the cloud version, removes the server and moves the concerns to internet reliability, browser and workstation performance, and how imaging is connected. I support both versions and say honestly which fits an office; more on that below.

When a problem is genuinely inside the product, I open the case with the vendor, provide the access they need, wait on the line, and confirm the fix from the operatory rather than the front desk.

Eaglesoft: what breaks and what I handle

Eaglesoft is the other practice management system I see in a large share of Dallas offices, typically alongside the supplier's imaging and equipment. It also runs on an in-office Windows server with a database engine, and it has its own habits.

• The database service. Eaglesoft depends on a database service running on the server. When it stops, every workstation loses the program at once, and the fix is usually on the server, not in the operatory. I monitor the service and keep it starting correctly after updates and reboots.
• Version updates and Windows updates. Eaglesoft updates and Windows updates each have a way of interfering with the other. I apply both on a schedule, outside patient hours, with a backup first, rather than letting Windows decide to restart the server at nine on a Monday morning.
• Integrated imaging. Eaglesoft is often used with the same vendor's sensors and imaging software, and the link between them is one of the more common things to break after a change on either side.
• Vendor remote access. The vendor's support desk will want to connect to the server. I make sure that access is controlled, logged and closed afterward, which matters for the safeguards described in HIPAA-compliant IT for dental offices.
• Reports and printing. Statements, treatment plans and insurance forms all go to specific printers with specific settings. A changed printer driver is a surprisingly frequent reason an office cannot print statements at the end of the day.

Open Dental: what is different

Open Dental is the third system I support regularly, and it attracts practices that want lower software costs and more control. It runs on an open database engine, on a server in the office or hosted by the vendor, and it is unusually flexible, which is both its strength and the reason it needs an IT person who knows it.

• Database engine. The database is standard and well documented, which makes backups, maintenance and moving to new hardware more straightforward than the closed systems, provided someone actually does them.
• Hosted option. The vendor can host the database, which removes the server and keeps the familiar desktop program. The trade is dependence on your internet connection, and a practice on a single cable line without a fallback should think about that before switching.
• Imaging bridges. Open Dental connects to most imaging systems through bridges that have to be configured on each workstation. When a sensor works in one room and not another, the bridge configuration is the first place I look.
• Customization. Practices customize Open Dental heavily, and those customizations need to be documented and carried forward through updates and server replacements. I keep that documentation.

Whichever of the three systems you run, the pattern is the same: a database, a server or a hosted service, workstations, imaging connected to it, and a backup. Knowing where each system keeps its data and how it likes to be updated is what lets me fix things quickly instead of guessing.

Why does dental imaging break, and who fixes it?

Imaging is the part of a dental office's technology that generates the most urgent calls, because a sensor that will not capture stops the appointment. Dexis, Schick and Sidexis, Carestream, Planmeca, Vatech and the rest differ in detail, but the failures I see across Dallas offices fall into the same handful of causes, and almost all of them are IT problems rather than software bugs.

1. Drivers and Windows. A sensor is a device with a driver, and a Windows update, a new workstation or a change to endpoint protection can break that driver. Imaging vendors often ask that their workstations not be updated at all, which creates a security problem I address by isolating those machines on the network instead of leaving them exposed.
2. USB and cabling. Sensors run over USB or over the network. A worn USB extension in an operatory, a hub that lost power, or a network cable that was never terminated properly produces "sensor not found" errors that look like software failures.
3. The bridge to practice management. Images are captured in the imaging software and attached to the patient in Dentrix, Eaglesoft or Open Dental through a bridge. When the bridge points at the wrong patient database path or a permission changed, images capture fine and then vanish.
4. Storage. Radiographs, intraoral photos and especially 3D scans are large. An imaging store that filled the server's drive, or moved to a new location without the workstations being told, is a common cause of capture failures and slow chart opening.
5. Panoramic and 3D units. These are network devices with their own addresses and their own software on a dedicated workstation. An IP address change, a new switch or a firewall rule can take one offline.
6. Backups that skip the images. A backup configured for the practice management database only, leaving years of radiographs on a single drive. I check for this on every first visit.

My approach is to document every imaging device, its driver version, its connection and its storage path, so that when something fails I can compare against a known-good state instead of starting from zero. When a problem is genuinely inside the imaging software, I work with that vendor's support on your behalf.

Should your practice keep a server or move to the cloud?

Every dental software vendor now offers a cloud version, and every dentist I meet has been told by someone that the server is obsolete. The honest answer is that both models work, and which one fits depends on the practice. Here is how I weigh it.

My general advice for a single-location Dallas practice with a working server that is under five years old: keep it, maintain it, back it up properly, and plan the cloud decision for when the server would be replaced anyway. For a new practice, a practice with two or more locations, or one whose server is at the end of its life, the cloud version is often the better answer, provided the office has a reliable primary internet connection and a cellular or second-line fallback. I set up both models and I am not paid by any vendor, so the recommendation is yours to trust or check. The multi-location case is covered in IT for multi-location dental groups in DFW.

Why are the operatory workstations so slow?

A slow workstation in an operatory costs time with a patient in the chair, and the usual response, buying new software or blaming the vendor, misses the cause. Here is what I actually find.

• Consumer hardware. An all-in-one bought at a retail store, with a slow drive and the minimum memory. Dental software with imaging wants a business-class machine with a solid-state drive and enough memory to keep the practice management client, the imaging software and a browser open at once. I specify Dell and Lenovo business lines, and the reasons are in buying and supporting Dell and Lenovo business computers.
• Wi-Fi where there should be a cable. An operatory workstation on Wi-Fi will be slow to open charts and unreliable for imaging. Every operatory gets a wired network drop; if the office was never cabled properly, that is the first fix.
• A tired server. If every workstation is slow at once, the workstation is not the problem.
• Too much running. Vendor utilities, a second antivirus, years of installed printers and toolbars. A clean, managed configuration with one endpoint product makes an old machine feel new.
• Old switches and network gear. A consumer switch under the front desk, an internet provider's router doing the firewall's job, a network that has grown by adding another small switch each time. This is one of the causes I walk through in why your dental office network keeps going down.

The fix is usually a combination: replace the two or three worst machines, cable the rooms that are on Wi-Fi, clean up what runs on every workstation, and check the server. That costs far less than a software change and it is done in a few visits.

How I work with the vendors' support desks

A practice manager's least favorite hour is the one spent on hold with a software vendor while patients wait. Part of what I do is take that hour off your plate.

When a problem is genuinely the vendor's, I open the case, describe the problem in the terms their technician needs, provide controlled remote access to the server, stay on the call, and confirm the fix from a workstation in an operatory. When the vendor says "that is your network" or "that is your IT company's problem", which they say often, they are talking to me already, and there is no round of phone tag between three parties. I also keep a record of every vendor case, what was changed and when, because the next problem is often the result of the last fix.

For updates, I coordinate with the vendor's release schedule, apply Windows and application updates on a plan rather than on the vendor's or Microsoft's timing, and make sure imaging workstations that the manufacturer wants left alone are protected another way. This is the everyday content of my managed IT service for a dental office: no ticket queue, an owner who knows your setup and a small team working from the same notes, and remote support around the clock with onsite visits by appointment across Dallas–Fort Worth.

Getting started, and what it costs

If you are choosing an IT provider for a practice that runs Dentrix, Eaglesoft or Open Dental, the first conversation is short and free: which system, which version, server or cloud, which imaging, how many operatories and workstations, and what is going wrong today. From that I can usually tell you what I would look at first.

Ongoing support is my managed IT service, billed per user or per device, month to month, cancel anytime, quoted after that conversation because a four-operatory office with cloud software is not the same work as a ten-operatory office with a server and 3D imaging. For context only, small business managed IT in the Dallas market is commonly quoted somewhere around $100 to $175 per user per month; that is a typical market range, not my price. If you have a single problem and no wish for an agreement, my hourly rates are $100 per hour remote and $150 per hour onsite during business hours, with a one-hour minimum; details are on the pricing page.

A practice that is being built from scratch has a different first conversation, covered in opening a dental practice: IT, cabling and network setup. For everyone else, tell me what you run and what is bothering you at contact, and I will tell you which column of the table it belongs in and what I would do about it.

Questions people ask

Written and reviewed by

Anthony Omini, founder of Cross River Tech

Over 15 years in IT across many industries, now running Cross River Tech, a small owner-led managed IT company in Dallas. Every article is written from his own client work and checked by him before it is published.

Tell me what your practice runs Dentrix, Eaglesoft or Open Dental, server or cloud, which imaging, how many operatories, and what is going wrong. I will tell you what I would look at first.

Ask Anthony(214) 612-7080About Anthony