Which is best for a new practice: Open Dental, Dentrix, or Eaglesoft?

There is no single best - it depends on your clinical preferences, budget, and integrations. From an IT view: Open Dental uses MySQL and is known for openness and value; Dentrix is long-established with on-premise and cloud options; Eaglesoft uses Sybase/SQL Anywhere and integrates with Patterson imaging. Pick the clinical fit, then design IT around it.

What database does each dental software use?

Open Dental runs on MySQL/MariaDB. Dentrix uses a proprietary database engine. Eaglesoft uses Sybase/SQL Anywhere. The engine matters for IT because it shapes performance tuning, backups, and the common failure modes your support provider needs to know.

Can these run in the cloud, or do I need a server?

Open Dental can be self-hosted or run through a cloud/hosted option; Dentrix has on-premise and cloud options in its family; Eaglesoft is typically on-premise. On-premise means a server and local backups; cloud shifts the burden to your internet connection and the vendor.

Open Dental vs Dentrix vs Eaglesoft for a new practice: IT considerations

7 min read · Published 2026-06-29 

open dentaldentrixeaglesoftpractice management softwarenew practice

Open Dental vs Dentrix vs Eaglesoft: which for a new practice?

All three are mature, capable dental practice-management systems, and the clinical choice is yours to make with your team. From an IT standpoint, the practical differences are the database engine, the typical hosting model, and the surrounding ecosystem: Open Dental runs on MySQL/MariaDB and is known for openness and a strong API; Dentrix (Henry Schein One) is a long-established, widely used system with on-premise and cloud options; Eaglesoft (Patterson) uses a Sybase/SQL Anywhere database and integrates tightly with Patterson imaging. This page covers the IT considerations, not which charts better.

The IT-level differences

Open Dental

Database: MySQL/MariaDB - widely understood, with a large tuning and tooling ecosystem.
Hosting: self-host on your own server, or use a cloud/hosted option through Open Dental or partners.
Notable for: openness, a robust API and integrations, and a reputation for flexibility and value.
IT considerations: performance rewards good MySQL configuration and a healthy server/network. (See Open Dental running slow.)

Dentrix

Database: a proprietary engine; the on-premise version is server-based.
Hosting: on-premise, with a cloud option in the product family.
Notable for: long market presence, broad third-party integration, and wide familiarity among staff and technicians.
IT considerations: sensitive to default-printer and database-connection issues. (See why Dentrix keeps crashing.)

Eaglesoft

Database: Sybase/SQL Anywhere, running as a server service.
Hosting: typically on-premise.
Notable for: tight integration with Patterson imaging and equipment.
IT considerations: the database service must be running and survive reboots/updates. (See Eaglesoft will not open after a Windows update.)

What actually drives the IT decision

Hosting model. On-premise means a server, local backups, and more local IT; cloud shifts the burden to your internet connection and the vendor. (See cloud vs on-premise.)
Imaging and integrations. Confirm your sensors, CBCT, and any e-claims or payment tools bridge cleanly into whichever system you pick.
Who supports it. Whatever you choose, a dental-fluent provider should know its database, its failure modes, and its quirks - not learn them on your time.

An honest note

There is no single right answer here - the best choice depends on your clinical preferences, budget, and the imaging and integrations you need. Pick the clinical fit first, then design the server, network, and support around its IT realities. We support all of them and have no stake in which you choose. (See What is a Dental RMM?.)