Open Dental vs. Dentrix: The Real Numbers Behind the Two Biggest Names in Dental Software

Dentrix and Open Dental sit at opposite ends of the dental software spectrum. Dentrix is the industry incumbent — 35,000+ practices, backed by Henry Schein, 30 years of market dominance. Open Dental is the open-source insurgent — transparent pricing, full source code access, and a fanatical user community. Both are primarily on-premise. Both are capable. But they are fundamentally different businesses selling to fundamentally different buyers.

Here's what actually matters when you're choosing between them.

Pricing: One Is Transparent, One Isn't

This is the single biggest difference and it tells you everything about each company's philosophy.

Open Dental publishes every price on their website:

Pre-pay discounts: 5% for 6 months, 10% for 1 year, 15% for 2-3 years. There's a 90-day money-back guarantee. Dental schools get the software free.

The eServices Bundle (texting, eClipboard, confirmations, web scheduling, and more) runs $165/mo/location. Individual add-ons are itemized — $45/mo for eClipboard, $75/mo for web scheduling, $35/mo for the mobile app. You pick what you need.

Dentrix publishes nothing. Every product page ends at "Request a Demo" or "Contact Us." Pricing is fully gated behind a sales conversation. Third-party estimates put Dentrix in the $500-800/mo range for a typical practice, but we can't confirm that because Henry Schein won't say.

TMR Take: When a vendor hides pricing, it's because showing it would hurt them. Open Dental's transparency isn't just refreshing — it's a competitive weapon. You can budget for Open Dental in five minutes. Budgeting for Dentrix requires a sales call, a demo, and a quote you can't comparison shop because you signed an NDA.

The 5-Year Cost Comparison

For a solo practice with 3 providers:

Even with Open Dental's full eServices bundle, you're saving roughly $16,000 over five years. Without the bundle, the gap widens to $25,000+.

Features: What You Actually Get

Insurance & Claims

This is where Dentrix flexes hardest.

Dentrix built Eligibility Pro — it scrapes 100+ CDT codes, frequency limits, and patient history from 40+ payor portals automatically. No separate login, no manual lookup. It auto-populates coverage tables and color-codes your appointment book by verification status. Their eClaims system connects to 1,300+ payors with a 97% clean claims rate on first submission. They claim practices save 4 hours per day on eligibility verification alone.

Open Dental handles claims through 20+ clearinghouses with solid editing, pre-authorization, and EOB processing tools. eBenefits provides electronic benefits verification. It works, but it's not the same depth of automation. Where Open Dental compensates is its integration ecosystem — partners like AirPay (1,200+ payers), DentalRobot, Foji, and BillNow plug in to provide AI-powered verification and claims automation. You choose your tools instead of being locked into one vendor's stack.

TMR Take: Out of the box, Dentrix's insurance workflow is best-in-class. But Open Dental's approach — core functionality plus a deep partner ecosystem — gives you more flexibility and often better pricing on individual components.

Imaging & AI

Dentrix integrates imaging directly into the PMS. One-click capture, cloud sync, auto-billing. Compatible with 150+ devices (2D, 3D, CBCT, CAD/CAM). Their Detect AI feature, powered by VideaHealth, is FDA-cleared for caries detection — it runs automatically as X-rays are captured and overlays color-coded findings. Dentrix claims 119% improvement in caries identification and 31% fewer missed lesions. They also offer voice-powered charting and AI-generated call summaries that go into chart notes.

Open Dental bridges to imaging software rather than building it in. Their AI option is BetterDiagnostics at $199/mo/location. It works, but the integration isn't as seamless as Dentrix's native approach.

Multi-Location Support

Dentrix offers Dentrix Ascend — a separate cloud-native product designed for multi-location practices and DSOs. Real-time dashboards, open API, built-in patient engagement. But it's a different product with different pricing, not just Dentrix in the cloud.

Open Dental documents 12 deployment options for multi-location setups — separate databases, shared via VPN, Middle Tier architecture, terminal server, replication, Galera Cluster, and their own Open Dental Cloud. Plus a Central Enterprise Management Tool (CEMT) for managing multiple locations. Volume pricing starts at 4 offices. It's more DIY, but the flexibility is unmatched.

Integrations

Dentrix lives inside the Henry Schein One ecosystem. That's powerful but closed — you get their imaging, their analytics (Jarvis), their payment processing (Dentrix Pay), their cybersecurity (TechCentral). It all works together. It doesn't play as well with outside tools.

Open Dental has the largest third-party ecosystem in dental software. Over 60 integration partners across marketing, revenue cycle, business intelligence, phone systems, charting, cloud hosting, and AI. Companies like Weave, Solutionreach, Podium, and dozens of AI startups build directly for Open Dental. The open API and open-source codebase make it the platform of choice for dental tech innovators.

Support & Training

Dentrix support hours: Monday-Thursday 6am-6pm MST, Friday 6am-5pm MST. Phone, chat, and ticket submission. They claim 97% customer satisfaction. They offer on-site training, online training, webinars, and guided onboarding — especially for Ascend. The Connected Care Essentials plan includes priority support, automatic updates, and in-product chat.

Open Dental includes phone, chat, and email support with every subscription — no separate support tier to buy. Training runs $50/hr online or $3,650/day for on-site. Pre-recorded webinars are free. The user forums and Facebook group are active, and there's a reference program where prospects can talk to current users before buying. The 90-day money-back guarantee means you can try it with a real safety net.

Who Should Choose Open Dental

• Cost-conscious practices — the math isn't close, especially for solo and small groups
• Tech-forward offices — if you have an IT person or tech-savvy manager, Open Dental's flexibility is a superpower
• Practices that hate vendor lock-in — you own your MySQL database, you have the source code, you can leave anytime
• Growing practices — adding providers costs $20/mo each, not a whole new pricing tier
• Multi-location groups that want control — 12 deployment options beats any competitor

Who Should Choose Dentrix

• Practices that want everything from one vendor — imaging, AI diagnostics, claims, analytics, cybersecurity, all integrated natively
• Offices with high staff turnover — Dentrix experience is the most common line on dental office manager resumes
• Practices prioritizing AI diagnostics — Detect AI's FDA clearance and native integration is genuinely ahead of the market
• Groups already in the Henry Schein ecosystem — if you buy supplies, equipment, and services from Henry Schein, the integration advantage is real

The Bottom Line

Open Dental gives you more control and saves you $15,000-25,000 over five years. Dentrix gives you a more polished, fully integrated experience with best-in-class insurance automation and AI diagnostics — at a price they won't tell you until you're on a sales call.

If transparency, cost, and flexibility matter most to your practice, Open Dental wins. If you want the deepest feature set from a single vendor and you're willing to pay the premium, Dentrix is the safer institutional choice.

Neither is wrong. But only one of them will show you the price before asking for your phone number.

Use our comparison tool to see how Open Dental and Dentrix stack up against Curve, CareStack, Eaglesoft, and 10 other options.