Open Dental is a widely used practice management system in US dentistry, and it has a reputation that cuts both ways. Offices that set it up carefully find it flexible, fast, and deep. Offices that install it and start clicking find it cluttered and confusing, and they spend years working around setup decisions nobody remembers making. The difference is almost never the software. It is whether someone on the team understood the structure before they started entering data.
This course is written for the people who actually run the system: practice owners, office managers, associates who want to chart efficiently, and new front-office staff who were handed a login and told to figure it out. It is independent. ChairsideSource is not affiliated with, sponsored by, or endorsed by Open Dental Software, Inc. Menu paths and feature names in this course were checked against the public Open Dental online manual, but Open Dental releases updates often, and your screens can differ depending on your version, which features your office has turned on, and whether you use the Clinics feature. When something here does not match what you see, the manual for your version wins.
Key takeaways
- Practice in a test database, never in your live one. Open Dental's free trial includes a demo database with fictional patients, and existing offices can work with their IT support or Open Dental to use a separate copy.
- Open Dental has seven main modules (Appointments, Family, Account, Treatment Plan, Chart, Imaging, Manage), and almost everything in the first six applies to whichever patient is currently selected.
- Your data lives in two places: a MySQL or MariaDB database and a separate A to Z folder for images and documents. Backups have to cover both.
- Permissions are assigned to user groups, not to individual users. Design your groups before you create users, and give every person their own login.
- Set up practice information, providers, operatories, definitions, and security before go-live. Changing them later is possible but messier.
How to use this course, and where to practice
Each module in this course builds on the one before it. Module 1 covers orientation and setup. Module 2 covers patient and family records, Module 3 covers the appointment book and recall, and Module 4 covers clinical charting and treatment plans. Later modules take on insurance, billing, reporting, and administration. Every module ends with practice exercises. Do them. Reading about the Pinboard is not the same as losing an appointment on it.
The single most important rule: do your practicing somewhere other than your live patient database. Anything you enter in production shows up on real schedules, real ledgers, and real reports, and some actions (merging patients is the classic example) cannot be undone.
Option 1: the Open Dental trial version
According to Open Dental's trial version page, the trial is free, does not expire, and installs two databases: a blank one for trying setup from scratch and a demo database preloaded with fictional patients and providers. That demo database is the best free sandbox available for learning. Know its limits before you rely on it:
- The trial is limited to 30 patients.
- It does not work with eServices (texting, web scheduling, patient portal) or the API.
- It does not include copyrighted CDT content. The trial uses temporary codes in place of real CDT procedure codes and does not include ADA claim forms. CDT codes become available once a registration key is issued. If you are following an exercise that mentions a code like D1110, expect to see a placeholder in the trial.
Open Dental's notes on the trial database also mention sample content such as example patients for perio charting and capitation, default blockouts, and sample auto notes. Explore them. They show you what a configured feature looks like.
Option 2: a copy of your own database
If your office already runs Open Dental, a test copy of your own data is the most realistic place to train, because it has your fee schedules, your appointment types, and your quirks. The Choose Database window (File > Choose Database) lets a workstation connect to a different database on the server, and the manual describes using it to switch between the regular database and a backup copy. Creating that copy is a job for whoever manages your server, or for Open Dental support. Do not improvise it. When you set one up, ask two questions out loud: how will staff know at a glance which database they are in, and what stops the test copy from sending anything real, such as claims, statements, or patient messages? Get clear answers before anyone logs in.
Common mistake: "Just this once" training in the live database. A new hire makes a fake patient called Test Test to practice scheduling, then forgets to remove it. Six months later it is on the recall list, in patient counts, and possibly attached to a real family. If you must demonstrate something live, use a real patient's record only for real work, and never create fake patients in production.
The seven modules and what each one is for
Open Dental is built as one main window with seven modules. You switch modules by clicking the buttons in the vertical toolbar on the left side of the window. If you need two views at once, such as the schedule and a patient's ledger, the manual's suggestion is to open a second instance of the program rather than flipping back and forth.
| Module | What lives there | Who uses it most |
|---|---|---|
| Appointments | The appointment book, Pinboard, appointment lists (Recall, Confirmations, ASAP, Unscheduled, Planned Appointment Tracker), daily production figures | Front desk, schedulers, everyone checking the day |
| Family | Patient demographics, family members and guarantor, recall grid, insurance plans attached to the patient | Front desk, insurance coordinator |
| Account | The family ledger: charges, payments, adjustments, claims, payment plans, statements | Billing staff, office manager |
| Treatment Plan | Active, inactive, and saved treatment plans, fees and insurance estimates, printing and signatures | Treatment coordinator, dentists, front desk |
| Chart | Graphical tooth chart, procedure entry, progress notes, planned appointments, perio chart access | Dentists, hygienists, assistants |
| Imaging | Radiographs, photos, scanned documents and forms, organized into image categories | Clinical team, front desk for scanned forms |
| Manage | Practice-level tasks: sending claims in batches, billing, deposit slips, tasks, time clock, backups, messaging | Office manager, billing staff |
The first six modules are patient-centered. The Manage module is practice-centered. That split explains a lot of Open Dental's behavior: if a screen is showing the wrong information, the first question is always which patient is selected.
The main menu, mapped
Above the modules sits the main menu. It is long, and the Setup menu in particular can feel overwhelming. Here is how it is organized in current versions, based on the manual's main menu reference. Items appear and disappear depending on your version and which features are enabled.
- File: per-user items such as User Password, User Settings, Printers, Graphics, and Choose Database.
- Setup: nearly all configuration. It is grouped into submenus that mirror the modules (Appointments, Family/Insurance, Account, Chart, Images, Manage), an Advanced Setup submenu (including Show Features and Computers), and a long list of practice-wide items such as Preferences, Definitions, Practice, Schedules, Security, Fee Schedules, Auto Notes, Auto Codes, Program Links, Required Fields, and Sheets.
- Lists: master lists shared by the whole database, including Procedure Codes, Providers, Employees, Employers, Insurance Carriers, Insurance Plans, Referrals, Medications, Allergies, and Problems.
- Reports: Standard reports, Graphic reports, and User Query (custom SQL queries), plus favorites. Module 7 covers them.
- Tools: utilities such as Misc Tools (where Merge Patients lives), Audit Trail, Aging, Billing/Finance Charges, Database Maintenance, and the Setup Wizard.
- eServices: setup for Open Dental's subscription services such as texting, web scheduling, and the patient portal. Module 8 covers them.
- Help: Online Help Contents and Index, Training Videos, Online Support, Update, and About (which tells you your version number, the first thing support will ask for).
Office manager tip: Write your current version number (from Help > About) at the top of your office manual and update it after every upgrade. When a staff member finds a manual page or training video that does not match the screen, the version is usually why.
Selecting a patient: the habit that prevents most errors
Open the Select Patient window from the main toolbar or with Ctrl + P. From there you can search by last name, first name, and other fields; the grid shows 40 results at a time by default, with Next 40 and Get All buttons for more. A few details matter more than they look:
- Show Inactive Patients and Show Archived/Deceased/Hidden Clinics checkboxes control whether those records appear. If you search for a returning patient and find nothing, check these before you conclude the patient does not exist. Unchecked boxes are the most common source of duplicate records.
- Guarantors Only limits results to the financially responsible person in each family, which is handy when a parent calls about a balance.
- Add Pt and Add Many buttons in the same window create new records. Only use them after you have searched properly, which Module 2 covers in detail.
Once a patient is selected, the Family, Account, Treatment Plan, Chart, and Imaging modules all show that patient (and in the Account module, that patient's family). Confirm at least two identifiers, such as full name and birthdate, before charting, posting a payment, or importing an image. Two patients with the same name in the same practice is ordinary, not rare.
Common mistake: Charting or importing radiographs on the previously selected patient. A hygienist opens the Chart module while the last patient is still selected, charts findings, and saves. The fix involves deleting and re-entering procedures, and if images were imported to the wrong patient, a privacy problem as well. Make "confirm the name in the title bar" a spoken step in your clinical routine.
How the database is structured, and why it matters later
You do not need to be technical to run Open Dental well, but a basic picture of how it stores data will save you from the most expensive mistakes.
One database, many workstations
Open Dental stores its data in a MySQL or MariaDB database. The manual describes it plainly as a collection of tables, roughly 400 of them, running on one server computer that every workstation connects to. New trial installations use MariaDB; older installations may still run MySQL. Each workstation finds the database through the Choose Database window, where you enter the server name and the database name (typically "opendental"). Offices that do not want to run their own server can look at Open Dental's hosted option, Open Dental Cloud, which Module 8 discusses alongside other infrastructure choices.
Images and documents live somewhere else
Radiographs, photos, scanned forms, and many documents are not stored inside the database. They live in the A to Z folder (by default named OpenDentImages), usually on the server, organized into lettered subfolders by patient last name. The database holds the records that point to those files. The folder's location is set in Setup > Data Paths. The practical consequence: a backup of the database alone does not back up your images. Module 8 covers backups in depth, but make a note now to confirm with whoever manages your server that both are backed up and that someone has tested a restore.
Records are connected, so errors spread
Every piece of data in Open Dental hangs off other data. A patient belongs to exactly one family, and each family has a guarantor. Procedures belong to a patient and may attach to an appointment and to a claim. Payments are split to procedures and providers. Definitions (the customizable lists behind billing types, confirmation statuses, blockout types, commlog types, image categories, and more) are referenced by thousands of records. That is why:
- A duplicate patient record splits one person's history across two charts, two ledgers, and possibly two recalls.
- A procedure entered under the wrong provider flows straight into production reports and, depending on your setup, associate pay calculations.
- A carelessly renamed definition changes its meaning on every historical record that uses it.
- Reports in Module 7 are only as good as the data behind them. If statuses, providers, and procedure codes are sloppy, the numbers will be too.
Hypothetical example: A front desk team member creates a new record for a returning patient because the old record was marked Inactive and hidden from search. The new record gets a fresh recall, new insurance entries, and a first-visit date. The patient's old unpaid balance now sits on the orphaned record, the hygienist cannot see prior perio charts, and the new-patient count for the month is overstated by one. One skipped checkbox, four downstream problems.
User accounts and permissions
Security is where Open Dental rewards planning more than anywhere else. The concepts are simple once you see them.
How Open Dental security works
- Users are individual logins with a user name and password. The manual is explicit that every person who uses Open Dental should have their own.
- User groups hold permissions. You check or uncheck permissions for a group, and every user in that group inherits them. You cannot grant a permission directly to an individual user.
- A user can belong to more than one group and receives all the permissions of every group they belong to.
- Users can be linked to an employee record (needed for the time clock) and to a provider record.
- Many permissions can carry a date restriction: a lock date or a number of days after which items can no longer be changed by that group. There is also a global lock date that applies across the practice.
- Only users with the Security Admin permission can open the security settings, and at least one user must always have it.
Setting up security, step by step
- Go to Setup > Security. The window has a Users tab and a User Groups tab, plus a Global Security Settings button.
- On the User Groups tab, click Add Group for each role you plan to have. The Set All button grants every permission except Security Admin, and Set None clears them, which is a fast starting point for building a group from the top down or bottom up.
- Check the permissions each group needs. For any permission with a date option, decide whether to add a lock date or a number of days.
- Open Global Security Settings and set a Default User Group (the manual notes one must be set before you can add users), your password rules, and your automatic logoff time.
- On the Users tab, click Add User (also available at Setup > Security Add User), enter the user name, set a password, assign groups, and link the employee or provider record. Copy User is useful when a new hire has the same role as an existing one.
- Log in as a test user from each group and try the things that group should and should not be able to do.
A starting design for user groups
Open Dental does not force a particular group structure. The table below is a common, sensible starting point, not an Open Dental default. Adjust it to your office, and document why each group has what it has.
| Group | Typical members | Usually grant | Usually withhold |
|---|---|---|---|
| Admin | Owner and office manager (two people, not one, not five) | Everything, including Security Admin | Nothing, which is why membership stays small |
| Front office | Receptionists, schedulers | Appointments, patient editing, payment entry, commlog, confirmations | Setup, Security Admin, Patient Merge, Payment Edit and Adjustment Edit on older dates, Appointment Delete |
| Billing and insurance | Billing coordinator, insurance coordinator | Claims, insurance payments, adjustments within a lock window | Setup, Security Admin, editing completed procedures |
| Clinical | Hygienists, assistants | Chart, perio, imaging, treatment planning, clinical notes | Payment and adjustment permissions, Setup |
| Doctors | Owner dentist, associates | Clinical permissions plus completed procedure editing within a short window | Security Admin for associates, financial edits |
Permissions worth deciding on deliberately include Setup (many configuration screens), Security Admin, Patient Merge, Appointment Delete, Completed Procedure Edit, TP Procedure Delete, Adjustment Edit, Payment Edit, Insurance Payment Create, Archived Patient Edit, Audit Trail, and the schedules permission that controls editing provider schedules. Permission names occasionally change between versions, so search the permission list rather than scrolling for an exact label.
Global security settings worth turning on
The Global Security Settings window includes options such as Passwords must be strong (at least eight characters with numbers and mixed case), Strong passwords require special character, Force password change if not strong, Log off user on Windows lock, and Automatic logoff time in minutes. In a dental office where screens face patients and workstations are shared, automatic logoff and strong passwords are basic HIPAA hygiene. Our compliance chapter covers the broader HIPAA picture; confirm your specific obligations with your compliance advisor.
Lock dates and the Audit Trail
Lock dates are how you keep closed months closed. Once you have reconciled a month's deposits and production, a lock stops ordinary users from editing payments, adjustments, or completed procedures dated before it. The Audit Trail (Tools > Audit Trail, which requires the Audit Trail permission) records user actions such as logins, appointment changes, and chart edits, with the user, date, patient, and workstation. It is the first place to look when a number changes and nobody knows why.
Common mistake: Shared logins. "Front desk" as a single user shared by three people makes the Audit Trail useless, makes lock dates meaningless, and means that when someone leaves, you either change a password everyone knows or leave a door open. One person, one login, always.
Office manager tip: Keep two Security Admin users (for example, the owner and the office manager) so that one person's absence or departure never locks the practice out of its own settings. Store the owner's credentials securely, and review group membership every time someone is hired, promoted, or leaves.
Preferences and setup to configure before you do anything else
Open Dental's preferences live at Setup > Preferences. In current versions the window is organized by module and topic: Main Window, Appointment (General and Appearance), Family (General and Insurance), Account (several topics including Adjustments, Insurance, Payments, and Recurring and Repeating Charges), Treat Plan (General and Frequency Limitations), Chart (General and Procedures), Imaging, Manage (General and Billing Statements), and Server Connections. The window has a search box, and many preferences show an "i" icon you can hover over for an explanation. Use both. Older versions organized preferences differently, so if your screen looks nothing like this, check your version's manual.
Preferences are only part of setup. The list below is the order that avoids rework, whether you are opening a new office or cleaning up an existing one.
Configure this first
- Practice information at Setup > Practice: practice name, phone, physical treating address, billing address, and pay-to address. The manual notes that sending electronic claims requires 9-digit zip codes. Also set the default provider and default billing type for new patients.
- Providers at Lists > Providers: every dentist and hygienist, with correct identifiers. Everything from scheduling to production reports keys off provider records.
- Employees and users: employee records, then user groups and users as described above.
- Show Features at Setup > Advanced Setup > Show Features: turn on only what you use (for example Clinics, Super Families, the Reactivation List, Medical Insurance, or Capitation). Hidden features keep screens simpler for staff.
- Operatories at Setup > Appointments > Operatories, and provider Schedules at Setup > Schedules. Module 3 walks through both.
- Definitions at Setup > Definitions: the office-specific lists behind confirmation statuses, blockout types, commlog types, recall and unscheduled statuses, treatment plan priorities, image categories, chart colors, and billing types. Settle naming conventions before staff start using them.
- Fee schedules and procedure codes: covered in Modules 4 and 5, but confirm early that your fee schedules exist and your code list is current.
- Required Fields at Setup > Required Fields: decide which patient fields your front desk must fill in (Module 2).
- Data Paths and backups: confirm the A to Z folder location and backup routine with your IT support before real data goes in.
The Setup Wizard
If you are starting from a fresh database, Tools > Setup Wizard walks through Registration Key, Basic Features, Providers, Employees, Fee Schedules, Clinics, Operatories, Practice Info, Printer and Scanner setup, and Definitions. Rows turn green when information has been entered and stay red when something is missing. It is a good checklist even for an existing office: open it and see what is still red.
Per-user settings
Some settings belong to the individual rather than the practice. File > User Settings includes options such as suppressing the logoff warning and whether chart graphics distinguish procedures completed by other providers. Show new staff where these live so they do not go hunting through practice-wide preferences to change something that only affects their own screen.
Common mistake: Changing a practice-wide preference to fix one person's annoyance. Preferences apply to everyone the moment you save. Before changing one, ask who else it affects, test it in your test database, and write down what you changed and when. A one-line setup log in a shared document prevents a lot of "it didn't used to do that" confusion.
A first-week orientation plan by role
New staff do not need to learn all of Open Dental. They need to learn their slice of it well, in the right order. A practical first week in the test database looks like this:
- Front office: Select Patient searching (with the inactive and archived boxes), adding a family, making and moving appointments, the Pinboard, confirmations, and commlog entries. Modules 2 and 3.
- Clinical assistants and hygienists: patient selection discipline, the Chart module, entering existing and planned treatment, progress notes, perio charting, and imaging. Module 4.
- Associates: charting, treatment plans with options, completing procedures and signing notes, and understanding how their production is attributed. Module 4, then Module 7 for reports.
- Office managers and owners: all of the above at a lighter level, plus security, preferences, definitions, and the lists behind reporting. This module, then Modules 5 through 8.
Pair the software training with your office's written procedures. Our chapters on onboarding new team members and documenting systems and workflows cover how to structure that. Open Dental's own Training Videos (under the Help menu) are also worth assigning, since they show the screens in motion.
Practice exercises
Do these in the trial demo database or a designated test copy, never in production.
Module 1 hands-on tasks
- Install the Open Dental trial (or connect to your office's test database) and confirm, using Help > About, which version you are running.
- Click through all seven modules with a demo patient selected, and write one sentence describing what each module is for.
- Open Ctrl + P, search for a patient, then toggle the inactive and archived checkboxes and note how the results change.
- Open Setup > Security, create a Front Office user group, and grant only the permissions from the table above.
- Create a test user in that group, log off, log in as that user, and confirm you cannot open Setup > Preferences or Tools > Misc Tools > Merge Patients.
- Open Setup > Preferences, use the search box to find three preferences related to appointments, and read the "i" explanation for each.
- Open Setup > Data Paths and write down where the A to Z folder is. Ask your IT support whether it is included in backups.
- Run Tools > Setup Wizard and list every row that is still red.
- Open Tools > Audit Trail, filter to your own user, and find the entries your practice session just created.
What's next
With the structure in your head and security in place, you are ready for the records everything else hangs on. Module 2: Patient Management covers adding patients and families, guarantors, patient status types, merging duplicates, and using notes and popups without burying the chart. If you want the bigger picture of where this course fits, the Open Dental course overview lists every module, and the dental business glossary defines the practice-management terms used throughout.
ChairsideSource is not affiliated with or endorsed by Open Dental Software, Inc. This is independent educational content. Menus and features change between versions: verify against the official Open Dental manual and contact Open Dental support before changing settings that affect live patient data. This guide is educational content and does not constitute legal, financial, tax, or clinical advice. Laws and regulations vary by state and change over time. Consult your own dental-specific attorney, CPA, and state dental board before acting.