Dental practice management software that fits how your practice runs
Dentally, EXACT, R4, Pearl and Aerona run most UK practices. Here's what each covers, what a system written around your practice would add, and how the cost compares with your subscription. A first release with the four core features typically costs £4,000–£5,500 and goes live within a month.
£495 for a working prototype in 5 days. It comes off the build.
Next First Gear slot: w/c 19 Oct · 2 of 3 builds booked this month
Is custom worth it for you?
Three questions, and a straight answer.
What dental practice management software does, and who offers it
Here are twelve things practices buy dental software for, and which of five UK systems do them. Mark the ones your practice relies on with “Need it”. If your current software covers all of them, stay put. If it doesn't, the price further down is worked out from your marks.
| Feature | Dentally | SOE EXACT | R4+ | Pearl | Aerona | Your practice |
|---|---|---|---|---|---|---|
| First release | ||||||
| Patient records and medical historyContacts, alerts, and a medical history updated at every visit | Yes | Yes | Not listed | Yes | Yes | |
| Appointment bookClinicians, surgeries and hygienist columns, with treatment-length slots | Yes | Yes | Yes | Yes | Yes | |
| Charting and clinical notesTooth chart and note templates, with every change dated and kept | Yes | Yes | Yes | Yes | Yes | |
| Treatment plans and estimatesPriced plans the patient signs on a tablet or online, then invoiced | Yes | Yes | Not listed | Yes | Yes | |
| Recalls and remindersExam and hygiene recalls and appointment texts and emails | Yes | Yes | Yes | Yes | Yes | |
| Online medical history formsPatients fill them in at home or on a tablet in reception | Essentials+ | Yes | Not listed | Yes | Yes | |
| Equipment and compliance logAutoclave tests, compressor and X-ray servicing, due dates flagged | Not listed | Not listed | Not listed | Not listed | Not listed | |
| Phase two | ||||||
| NHS courses and UDA trackingBands and UDAs counted against your contract, with claim deadlines flagged | Yes | Yes | Yes | Yes | Yes | |
| Membership and payment plansYour own monthly plans by Direct Debit, with what's included tracked | Yes | Yes | Denplan | Not listed | Yes | |
| StockMaterials by surgery, with reorder levels | Not listed | Yes | Not listed | Not listed | Not listed | |
| Patient portal and online bookingPatients book, pay deposits, sign plans and see what they owe | Essentials+ | Yes | Not listed | Yes | Yes | |
| Group reportingTakings, chair time and recalls side by side across every practice | Essentials+ | Add-on | Yes | Yes | Add-on | |
From each product's own site, checked Oct 2026: Dentally, SOE EXACT, R4+, Pearl, Aerona. “Essentials+” means Dentally's Essentials plan and up. “Add-on” means a separate product from the same company (SOE's My Practice Cloud, Aerona's Multisite). Denplan means Denplan schemes only. Aerona's NHS mark comes from NHSBSA's list of certified software. A dash means the product's site doesn't list it.
Next: the tools it connects to ↓Where a build starts, and what comes next
The first release handles a patient’s visit from start to finish: their record and medical history, the appointment, the chart and notes, and the treatment plan they sign before it’s invoiced. Your income and the records the GDC and CQC look for both run through those four, so they come pre-selected.
Recalls, online medical history forms and an equipment log can be added to it straight away. NHS course tracking, membership plans, stock, a patient portal and group reporting form phase two, with its own fixed price and about four weeks of work.
The equipment log is there because most practices still keep these checks in a folder: daily autoclave tests, the compressor’s written scheme, X-ray servicing and radiation protection checks, each with its due date flagged before it lapses.
What AI can do here
Places it earns its keep in a surgery, while clinicians keep every decision:
- Draft the clinical note. The dentist dictates during the appointment and the note drafts itself in your template, for the dentist to edit and sign.
- Explain the treatment plan. It turns the plan into a plain-English summary the patient takes home, checked by the clinician first.
- Chase unsigned forms. It spots tomorrow’s patients with an out-of-date medical history and sends them the form.
Every AI draft is checked by a clinician before a patient or the record sees it. These come once the system is live, priced separately at £1.5k to £5k.
What it connects to
Choose the imaging, accounts and payment services in use at your practice today. Each one you choose is added to the first release's price.
Switching from your current system
What comes across. Patients, contacts and medical histories, appointments past and booked, charts and clinical notes, treatment plans and signed consent, ledgers and balances, recall dates and membership plan members.
X-rays and documents. They’re part of the import and its price. Charting kept in a format only the old vendor reads becomes records again where the export allows it; where it doesn’t, I attach the vendor’s PDFs to the right patient so nothing is lost.
How. Everything lands in a trial copy first. Your reception team checks patients they know against the old system, and I correct anything that differs before you switch. Ask for your export before you give notice.
What your current system lets you take
What each vendor's help pages and contract terms said in Oct 2026, and for the gaps, what I'd ask their support desk.
I'm on Dentally
- A full export is requested from Dentally's support by an admin user. You then have 30 days to download the files, and they hold the data for up to 90 days before destroying it.
- Some reports export as CSV yourself, and each patient's treatment history downloads as a PDF.
- I'd ask them what the full export contains (appointments, charting, notes, ledgers, signed forms, images), its format, and whether there's a fee.
I'm on SOE EXACT
- EXACT's database sits on your own server, so the data is already in your building. Patient lists also export to CSV.
- Their terms delete anything held in SOE's cloud 90 days after you cancel, and their data processing terms promise to return your personal data on written request.
- I'd ask SOE how charting, notes, ledgers and Examine Pro images are handed over, and in what format.
I'm on R4+
- Sensei's terms give you 60 days after the contract ends to download your data, and say they may charge for transferring it. Reports export to Excel.
- I'd want a full database export from them, with its format and fee, and to know whether images in VistaSoft come out with it.
I'm on Pearl
- Pearl's FAQs list conversions into Pearl from other systems, but I found nothing on exporting when you leave.
- I'd ask them what a full export contains (patients, appointments, charting, notes, ledgers, documents, X-rays), its format and cost, and how soon they delete it once you've cancelled.
I'm on Aerona
- On written request, Aerona's terms give you their most recent back-up of your data, at your reasonable cost. Data is destroyed within 90 days of the contract ending.
- The terms don't name a format. I'd ask whether the back-up is a database file or CSVs, and whether images and signed documents are in it.
What you pay now, against a build
It opens on a three-surgery practice paying for Dentally Essentials. Swap in your surgeries, practices and current software, then pick the period.
£380 a month ex VAT
Breaks even in month 26
The build is the middle of your estimate (£4,750), paid up front. The first month's hosting is free, so the plan starts in month two, and one plan covers every practice. Subscription prices are list prices ex VAT and leave out set-up fees and price rises.
What dental software costs
List prices ex VAT, from each vendor's pricing page, checked Oct 2026.
| Product | Price | Worth knowing |
|---|---|---|
| Dentally | Per practice by number of surgeries: Starter £125 to £575, Essentials £220 to £720, Pro £320 to £945 a month. 9+ surgeries are quoted. | Unlimited users on every plan. The portal, Dentally Vision imaging and multi-site start at Essentials. |
| SOE EXACT | Quote-based. A licence for each computer that runs it. | Runs on a server in your practice. SOE is part of Henry Schein One, which also owns Dentally. |
| R4+ (Sensei) | Quote-based. | Sensei's terms don't allow ending a plan without cause in the first 12 months. |
| Pearl | £82 a month for the first surgery, £58 for each extra. Online booking £40 to £100 a month; SMS £100 per 1,000. | Rolling contract. Onboarding is quoted separately. |
| Aerona | Quote-based. | Single-site and multi-site are separate products. |
When off-the-shelf is enough
Where most of your work is NHS, certified software that sends claims straight to the NHSBSA and counts UDAs for you is the right tool, and a build would only add a step. A subscription is also the better buy if:
- you’re opening a single practice and want to be booking patients next week;
- you’re happy inside one vendor’s imaging and patient app;
- your team knows the system and nothing important lives in spreadsheets.
Building makes sense for private and specialist practices whose plans, referrals or fees don’t fit the software, and for groups paying a subscription at every site.
Open-source software you could run instead
You could also run free software on your own server and change it as you like. Open Dental, once the best-known option, stopped being open source in 2024, and none of what's left handles NHS claims or UDAs. These two are maintained, each checked Oct 2026.
- DinoDent GPL-3.0
Good for: A real dental practice system: tooth and perio charting, treatment records and invoices.
Missing for you: Built for Bulgaria's national health fund, so the claims, codes and wording are Bulgarian.
- GNU Health (dentistry module) GPL-3.0
Good for: An odontogram, dental procedures and treatments inside a full health information system.
Missing for you: Made for hospitals and public health. Heavy to run for one practice, and nothing UK-specific.
Want to go the open-source way? I can install and host either one and write the UK pieces it lacks: your fee scale, recalls and payment plans.
Your plan, priced in two phases
What you chose, in two phases with a price range on each. Email yourself a copy or pass it to me.
First release
The first month after kickoff
- Patient records and medical history
- Appointment book
- Charting and clinical notes
- Treatment plans and estimates
Phase two
About a month, after the first release is in use
Nothing picked yet
- First release estimate
- £4,000–£5,500
- Phase two estimate
- None picked
- Break-even on Cruise
- Month 26
Estimates, not quotes: First Gear ends with a fixed price for the first release.
How the estimate works
Each phase starts at £1,500 for what every system needs: logins, hosting, backups and your data imported. Each feature and connection adds £250 to £1,250 depending on its size, and the range is 15% either side of the total. The break-even uses the middle of both phases.
A Thursday, before and after
Imagined for a three-surgery private practice; no real practice’s diary was used.
| Before | After | |
|---|---|---|
| 8am | A nurse runs the autoclave test and writes the result in a folder. | The result goes into the equipment log on a tablet, and a missed test shows red on the morning screen. |
| Mid-morning | A patient arrives with an out-of-date medical history and fills in paper at the desk. | They completed it from a link the evening before, and it’s on the chart when the dentist opens it. |
| Afternoon | An implant plan is printed, signed and scanned back in. | The patient signs the plan on a tablet and the deposit is taken from the same screen. |
| Month end | Membership payments are matched to patients in a spreadsheet. | GoCardless payments land against each patient’s plan, and lapsed members are listed for reception. |
The regulators and rules behind dental records
- CQC. Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 asks you to keep “an accurate, complete and contemporaneous record” for each patient, securely, along with records about staff and how the practice is run.
- GDC. Standard 4 says you must keep contemporaneous, complete and accurate records, including an up-to-date medical history each time you treat a patient and evidence of valid consent, with changes clearly marked and dated. From 2 June to 31 August 2026 the GDC consulted on a Framework for Professionalism that would replace these Standards, so I’d check the current wording before go-live.
- NHS claims. FP17s must reach the NHSBSA within 2 months of completing a course of treatment, electronically, through certified software or Compass. Compass is due to be replaced by the NHS Dental Services Portal.
- How long records are kept. The NHSBSA’s records retention guidance gives 11 years for clinical records, 2 years for finance records, and 2 years from the end of the course of treatment for PR forms. It points to NHS England’s Records Management Code of Practice for the rest, so check that for children’s records before setting a retention rule.
- Data Security and Protection Toolkit. Every organisation with access to NHS patient information has to complete it, dentists included (with a shorter assessment than a hospital trust), and publish an assessment by 30 June every year.
- UK GDPR. Dental records are health data, a special category that needs both a lawful basis and a condition for processing.
The system is designed with each of these in mind, but compliance stays with the practice. Before go-live your practice manager and I go through every rule and how the software supports it.
Is my data safe?
Who sees what depends on the job: reception has the book and accounts, clinicians see charts and notes, only the practice manager sees staff records. An audit log records each time someone opens or edits a patient. Charts, X-ray references and medical histories are encrypted at rest and hosted inside the UK or EU; a second copy is written every night, and a complete export is yours on request at any time.
Will my team use it?
A dentist spends the day on three screens: the book, the chart and the notes. I build those for speed with a mouse and keyboard in the surgery. In First Gear, a dentist and nurse from your team run a real appointment through the prototype, and every snag they hit is on my list before any code is written.
Other ways to solve it
| Choice | Price | Right for | Weak spot |
|---|---|---|---|
| Dental practice software | A monthly fee per surgery or a quote | NHS and mixed practices, single sites | Plans, referrals and logs it can’t hold end up in spreadsheets |
| Custom build | First Gear and a fixed-price build; a run plan is optional | Private and specialist practices, groups | You pay up front, and NHS claims still go through the NHSBSA’s form |
| Open source (DinoDent, GNU Health) | The software is free; the server and the set-up aren’t | Owners who want the source code and can wait for UK features | Neither handles NHS claims, and the UK parts need adding |
| Paper records and Excel | Nothing | A visiting specialist with a handful of patients | No audit trail, and recalls depend on someone remembering |
Four guarantees, in writing.
They're written into the terms you accept when you pay.
Every build also comes with a 30-day fix guarantee. If something I built doesn't work as the plan describes, I fix it free.
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See it first
You click through a working prototype before you commit to the build, and you keep it either way.
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Fixed price
You pay the price in the build plan. New ideas go into a later phase with its own fixed price. Nothing is billed by the hour.
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On time
If I miss the go-live date in your build plan because of a delay on my side, you get 3 months of Cruise free (£597). If your data, feedback or sign-off is late, the date moves by the same number of days.
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Yours to keep
Code, data and accounts are in your name from day one. Export your data or cancel a plan whenever you like, and ask for a full handover pack.
You'll talk to me
I've built software for over ten years and started ByteGears in 2020. The person on your kickoff call is the person who writes the code. Recent work includes quoting automation for a renewable-energy installer and a cask whisky auction platform with ID and anti-money-laundering checks.
Questions about a dental build
Can a custom system send NHS claims?
FP17 and FP17O claims go to the NHSBSA either from certified practice software or through the free online form in Compass, which is due to be replaced by the NHS Dental Services Portal. A system I build tracks each course of treatment, its band and the UDAs against your contract, and the claim goes in through the NHSBSA's own form. For a mostly NHS practice, certified software that sends claims directly is usually the better choice.
Does a build work out cheaper than Dentally or Pearl?
Against Pearl, no. Against Dentally's Essentials or Pro plans, a small build can come out ahead within a few years, and step 3 runs the sums for your surgeries. For a group the gap widens, because each practice pays its own subscription and the run plan is one fee for all of them.
Can you move our X-rays across?
Yes, along with charting, notes, ledgers and signed forms, and it's priced into the import. Images usually live in a separate imaging system, so I link the new records to it or move the files with their dates and patient attached, depending on what your imaging software allows.
How long before we can switch?
First Gear's 5 days end with the go-live date agreed in writing. Starting at the beginning of a month works best, with the old system kept read-only as a fallback.
What are the running costs once it's live?
Hosting is free for the first month, and anything broken in the first 30 days I fix at no charge. From month two it's Idle at £79, Cruise at £199 or Overdrive at £449 a month, or your own hosting. The fee stays the same however many surgeries or clinicians you add.
Let's get the gears turning.
Send me your plan. If First Gear is the right start, I'll reply with a payment link that holds your slot. If an off-the-shelf product would serve you better, I'll name it.