Dental IT Services: What a Modern Practice Actually Needs

A modern dental practice needs three things working together: PIMS/EMR software integrated with imaging and billing, HIPAA-aligned controls with a signed BAA covering any AI in the clinical workflow, and a record that treats a new inquiry as a lead with a lifecycle, not a chart from day one. Most stacks handle the first two and skip the third.

**Key numbers**
- Builder Pod: $5,000/month, one active build track, a pod lead plus a two-engineer bench.
- Growth Pod: $10,000/month, two concurrent build tracks, a pod lead plus a three-engineer bench.
- Our dermatology build pod, the closest published comparable, is scoped for deployment in 2-3 weeks (asaasin.ai/industries).
- All pods run month-to-month with a 30-day cancellation notice, no per-hour billing.
- A pod starts working within five business days of a signed engagement, with first shipped work in week one or two.

## What "dental IT services" actually means in 2026

The phrase covers three different jobs that most vendors bundle under one line item, and conflating them is where practices get burned.

The first job is infrastructure: keeping the network, the workstations, the backups, and the phones running. This is the traditional managed-IT scope, and it is table stakes, not a differentiator.

The second job is practice-management software (PIMS) and its integrations: scheduling, charting, billing, imaging, and increasingly a clinical AI layer that drafts notes or reads radiographs. This is where most of the actual patient-care workflow lives, and it is where the biggest gaps show up, because incumbent PIMS platforms were built as record-keeping systems, not growth systems.

The third job is compliance: HIPAA-aligned controls, signed Business Associate Agreements, audit logging, and access control that survives an actual audit rather than a sales deck. A practice can have excellent infrastructure and a modern PIMS and still fail this third job if nobody wired the audit trail correctly.

A modern practice needs all three handled coherently, and increasingly needs the second and third jobs owned by the same team, because compliance is not a layer you bolt onto a clinical system after the fact. It is a property of how the system was built.

## The real gap: a lead is not a chart

Here is the specific failure pattern. A prospective patient submits a contact form on the practice's website, or calls in with a general inquiry. The PIMS software, the moment that contact enters any record at all, treats it as a chart: a patient with an ID, ready for the clinical workflow. There is no concept of "this is a lead, still deciding, needs a follow-up before they book," because the system was never designed to think that way.

So the practice bolts a CRM or a marketing tool on the side. Now there are two systems that do not talk to each other. Front-desk staff re-enter the same contact by hand. Follow-up sequences run in one tool while the actual booking status lives in another. Every manual re-entry is a place a lead falls through, and it usually surfaces weeks later, when someone notices the intake numbers do not match the number of patients actually treated.

We built the fix for a dental sleep and airway medicine group: a unified practice EHR with lead management native to the patient record, not bolted next to it. Inquiry, CRM lifecycle, and clinical chart live in one system, on one schema, so a contact's status moves from "inquiry" to "scheduled" to "screened" to "in treatment" without a re-entry step anywhere in between. The build also included dual-path airway and sleep screening, two distinct clinical intake flows feeding the same record, role-based access so front-desk, clinical, and admin users see only what their role needs, and an imaging pipeline for cone-beam 3D scans and sleep-test data. Every requirement in the brief was tracked against a traceability matrix, so each line item maps to shipped, tested code rather than a promise in a proposal document.

The stack was Next.js on the front end, FastAPI serving the API layer, SQLModel for the data layer, and Alembic managing schema migrations as the record evolved. That combination matters for a reason beyond taste: a typed API contract and reviewed migrations mean a schema change to the patient record goes through the same gate as any other code change, which is exactly the discipline a compliance-conscious build needs. Full detail on that specific build is in [how we built an EHR that treats a lead as a lead](/blog/dental-ehr-lead-to-chart).

The pattern generalizes past dental. Our dermatology build pod covers the same shape of work: routing patient-submitted photos into the practice's existing PIMS (ModMed, Nextech, or EMA) and auto-verifying PPO or HMO pre-authorization for procedures like Mohs surgery or biopsies before the patient arrives, scoped for deployment in **2-3 weeks**. That is the closest published comparable we have for how fast a regulated, PIMS-integrated build moves when the scope is a clearly defined workflow rather than a full platform replacement.


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## How a build like this actually gets scoped and shipped

The process is the same one we use across every regulated build, dental or otherwise, and it is worth naming so a practice knows what to expect before signing anything.

1. A single scoping session, where we dig into what the practice actually needs: which PIMS is in place today, what the inquiry-to-chart handoff looks like now, what compliance posture already exists.
2. A free clickable prototype, built to show exactly how the unified record or the integration point would work. The practice commits to nothing at this stage. If the prototype does not earn a build, the practice keeps it.
3. The pod starts, working inside the practice's own repository and cloud account from day one. The pod is live within five business days, with first shipped work landing in week one or two.
4. Daily standups happen in the practice's existing channels, not a separate vendor portal. Weekly shipped increments, not a quarterly milestone review.
5. Handover includes the repository, the migrations, the deploy pipeline, and documentation, at any point the engagement ends.

Full detail on that sequence lives on the [how it works](/how-it-works) page. The point that matters most for a dental practice specifically: a scoped integration is a weeks-long piece of work, not a multi-quarter roadmap. The dermatology comparable above is scoped in the same 2-3 week window, and a dental build of similar scope, integrating lead management into an existing chart, or adding a screening workflow, tracks the same order of magnitude.

## What it costs

Dental IT vendors quote in wildly inconsistent units: hourly managed-service retainers, per-seat licensing for the PIMS itself, and separate development quotes for anything custom. A pod collapses that into one monthly number.

| Option | Monthly cost | Team | Commitment |
|---|---|---|---|
| Builder Pod | $5,000/month | Pod lead + 2-engineer bench, 1 build track | Month-to-month, 30-day notice |
| Growth Pod | $10,000/month | Pod lead + 3-engineer bench, 2 build tracks | Month-to-month, 30-day notice |
| Enterprise Organization Pod | Custom | Dedicated senior lead + 3-8 engineers, 3+ tracks | Custom terms |
| One in-house senior engineer | Roughly $250,000/year or more, fully loaded (an estimate, varies by role and region) | 1 engineer | Standard employment, typically a 3-6 month hire cycle |

A Builder Pod covers a single build track: the lead-to-chart integration, or the compliance audit-log layer, run as one focused piece of work with a lead and a bench behind them. A Growth Pod runs two tracks at once, which is the more common fit for a practice group tackling both a PIMS integration and a patient-facing intake overhaul in parallel, and adds architecture planning and a hosting discount. Enterprise scope applies to multi-location groups running parallel builds across departments, with a dedicated senior lead owning architecture and executive roadmap reviews.

None of these are per-hour arrangements, and none require a statement-of-work renegotiation to add scope inside the existing track. Full pricing detail, including what changes between tiers, is on the [pricing page](/pricing). A broader look at how pods are structured and staffed is on the [pods page](/pods).

## When a pod fits, and when it does not

A pod fits a practice or practice group that has a defined build (a lead-to-chart integration, a compliance audit layer, an AI scribe wired into an existing PIMS) and needs it built correctly, in weeks, without carrying a full-time engineering headcount that sits idle between projects. It also fits a practice comparing options that has never hired an engineer before and needs the deliverable, the code ownership, and the timeline stated in plain terms rather than a scope-of-work document full of hedges.

A pod does not fit a practice that needs someone physically on-site swapping out network hardware or managing workstation endpoints. That is traditional managed IT, a different service entirely, and conflating the two is exactly the bundling problem described earlier. A pod also is not the right tool if the practice's actual need is ongoing help-desk support rather than a defined engineering build; that is a staffing problem, not a build problem, and a comparison of staffing models generally is covered in [what is staff augmentation](/blog/what-is-staff-augmentation).

For practices sizing up their overall software strategy rather than a single build, the broader landscape of PIMS options and cloud-based practice management platforms is covered in the [dental practice management buying guide](/blog/dental-practice-management), which is a useful companion read before scoping anything custom.

## What "HIPAA-compliant IT services" actually has to mean

This phrase gets used loosely enough in dental IT sales conversations that it is worth stating precisely what it can and cannot mean.

There is no such thing as "HIPAA certified." HIPAA has no certifying body and no certificate to hold, and any vendor claiming one is either confused or misrepresenting their compliance posture. The honest, verifiable claims are narrower and more useful: a signed Business Associate Agreement, and HIPAA-aligned technical and administrative controls a practice's own compliance officer can inspect.

Concretely, here is what we mean by that when we build for a regulated practice:

- We sign a BAA on request, before any protected health information touches the system.
- We deploy inside the practice's own cloud account or VPC, not a shared multi-tenant environment we control.
- We build role-based access control, so a front-desk user cannot see clinical notes and a billing user cannot see imaging.
- We build audit logging on every access to a patient record, reviewable independently of us.
- We can share a SOC 2 Type II report under NDA, covering the security controls of our own engineering organization.
- Schema and code changes to anything touching patient data go through pull-request review by a named engineer, with typed contracts and tests in CI, not an unreviewed script run against production.
- We do not train AI models on client data unless the client explicitly requests it.

Full detail on our security posture, including how the BAA process and audit logging actually work, is on the [security page](/security). For a more general treatment of what "HIPAA compliant software" requires as a category, independent of any one vendor, see [HIPAA compliant software: what it actually requires](/blog/hipaa-compliant-software). Two HIPAA-aligned platforms we have shipped, a compounding-pharmacy portal and a Medicare/Medicaid medical-billing audit platform, are useful reference points for the level of audit rigor a regulated build should carry, even outside dental specifically.

## A checklist before signing with any dental IT vendor

Here is what we would want a practice to ask any vendor, including us, before signing anything.

1. Ask for the exact price, month to month, with the cancellation terms in writing. If the answer is a range instead of a number, keep asking.
2. Ask whether the code, the data, and the deploy pipeline live in your own repository and cloud account, or the vendor's. If it is the vendor's, ask what happens to your system if you leave.
3. Ask for a signed BAA before any patient data is discussed, not after a contract is signed.
4. Ask whether the vendor will claim "HIPAA certified." If they say yes, that is a red flag, not a reassurance.
5. Ask how a lead status moves from marketing intake to a booked appointment inside their proposed system, specifically. If the answer is "you'd use a separate CRM," you are looking at the same fragmented pattern described above.
6. Ask what the actual timeline is for a first shipped, working piece of the system, not a project-plan Gantt chart. Weeks is a reasonable answer for a scoped build; a quarter is not, for a single integration.
7. Ask who reviews AI-generated code before it merges, and whether typed contracts and tests run in CI. "The AI wrote it and we shipped it" is not an answer that should satisfy a compliance-conscious buyer.

## The short version

Dental IT services in 2026 need to cover three distinct jobs coherently: infrastructure, a PIMS and its integrations (including any AI in the clinical workflow), and compliance that holds up under actual audit. The most common failure is architectural, not technical: practice-management software treats an inquiry as a chart on day one, with no concept of a lead lifecycle, and that gap is where revenue quietly leaks. A unified record that treats inquiry, CRM lifecycle, and clinical chart as one system closes that gap, and comparable regulated builds move in weeks, not quarters. Any vendor claiming "HIPAA certified" is misrepresenting a category with no certificate; the honest, checkable claims are a signed BAA, HIPAA-aligned controls, audit logging, and code that lives in your own repository from day one.