The Real Price of Dental Tech Stack: Owner Audit Guide

You know what your PMS costs per month. You probably know what you pay for your phone system and your texting platform. But can you answer this question: what is the total annual cost of every technology tool your practice uses — including the staff time spent moving data between them?

Most practice owners cannot. And the gap between what they think they spend on technology and what they actually spend is where some of the most recoverable overhead lives.

Direct technology expenses — software and hardware alone — typically run 1–3% of collections for most general practices. That sounds modest until you add the staff hours spent re-entering data between systems, the integration fees billed quarterly, the answering service you forgot to cancel, and the productivity lost when two tools show conflicting patient information.

This guide is a hands-on audit framework. If you have already read our Dental Software Stack: Fragmentation Guide, you understand the concept of fragmentation cost. This article gives you the spreadsheet — the specific steps to quantify what your stack is costing and where the recoverable waste lives.

Step 1: Inventory Every Tool You Pay For

The first step is a complete inventory. Most practice owners underestimate their tool count because each was added incrementally. A typical practice runs five to seven separate software systems — and that often undercounts hardware, integration middleware, and tools that bill annually.

Pull every recurring charge from the last 12 months of bank and credit card statements. Then walk through this checklist:

Clinical systems: PMS, imaging software, charting add-ons, treatment planning tools

Communication tools: Texting platform, email marketing, patient reminder system, reputation management, online scheduling widget, web chat

Phone and call handling: Phone system/VoIP, answering service, AI receptionist, call tracking numbers

Billing and insurance: Clearinghouse, eligibility verification, patient financing platform, payment processing

Marketing: Website hosting, SEO tools, ad management platform, analytics dashboard

Infrastructure: Server maintenance or cloud hosting, backup service, cybersecurity tools, IT support contract

For each tool, document the monthly cost, contract renewal date, and number of staff who actively use it. You will need all three for the next steps.

Step 2: Calculate Direct Annual Cost

Direct cost is the straightforward part: the sum of all subscription fees, licensing, maintenance contracts, and hardware depreciation across a 12-month period.

PMS platforms alone range from $139–$349/month depending on the vendor and tier, with Open Dental starting around $169/month and Curve Dental around $299/month per provider. But the PMS is typically only 30–40% of total software spend. Layer on a texting platform ($200–400/month), an answering service ($200–600/month depending on call volume), a phone system ($100–300/month), call tracking ($50–150/month), reputation management ($100–300/month), and a marketing dashboard ($100–500/month) — and the numbers compound quickly.

Industry benchmarks put total overhead at 59–62% of collections, with equipment and facility costs at or below 10% and administrative costs (including software, billing services, and supplies) at 6–8% of revenue. If your total technology line items significantly exceed 3% of collections, you have room to optimize.

Direct Cost Audit Table

Use this format to total your direct technology spend:

This table gives you a number. But it is not the real number — because it does not capture indirect costs.

Step 3: Quantify the Costs That Never Show Up on an Invoice

The hidden costs of a fragmented tech stack are not billed monthly. They show up in staff time, missed opportunities, and operational friction. Here is how to estimate them.

Data re-entry time

Every time a staff member copies information from one system into another — entering a new patient's online form data into the PMS, transferring a text thread summary into the chart notes, logging a phone call outcome into the marketing dashboard — that is a cost. It is a salary cost, and it is measurable.

Time it. Have your office manager track, for one week, every instance where a team member manually transfers data between systems. Multiply the weekly total by the average hourly wage for the staff member performing the task ($18–25/hour for front desk), then annualize it.

Most practices that run this exercise find 5–10 hours per week of data re-entry across the front desk team. At $20/hour, that is $5,200–$10,400/year in labor that does not touch a patient.

Missed calls and callback failures

Your recall campaign sends 200 texts. Thirty patients call back. If your front desk misses six of those calls because they are handling check-ins, those six patients do not leave a voicemail — roughly 20% of dental practice calls go unanswered during business hours. At $200+ per hygiene visit (using the conservative figure from our Recall Gap analysis), six missed recall callbacks per week represents over $62,000/year in appointments that were ready to book but never connected.

This is one of the highest-ROI problems to solve in a tech stack audit, and it is why DentiVoice exists. When a recall patient calls back during the lunch rush or after hours, DentiVoice answers, identifies the patient, and books directly into your PMS — Dentrix, Eaglesoft, Open Dental, or Curve. No voicemail. No callback loop. The appointment lands on your schedule on the first attempt.

Context loss on callbacks

When a patient calls about a text they received and the person answering cannot see that text thread, the call takes longer. If context-switching adds 2–3 minutes per call across 40+ daily calls, that is 80–120 minutes of reconstructed information per day — roughly $8,000–$12,000 annually at front desk wages.

Attribution blindness

This cost is not labor — it is marketing waste. If you cannot tie a booked appointment back to the campaign that generated the call, you cannot optimize ad spend. You may be spending $3,000/month on Google Ads that produce clicks but not appointments, while a $500/month direct mail campaign generates your highest-value new patients. Without end-to-end attribution, you are flying blind on your most expensive variable cost.

How much of your tech budget is spent on tools that don't talk to each other?Book a free stack assessment and see where DentalBase consolidates your phone, texting, call handling, and attribution into one connected platform.

Step 4: Identify Overlap and Consolidation Opportunities

With your inventory complete and indirect costs estimated, look for three specific patterns:

Redundant communication tools. Many practices run a texting platform, a separate patient reminder system, a reputation management tool, and an answering service — four tools that all involve communicating with patients through different channels but do not share a patient timeline. If one platform could handle texting, reminders, review requests, and call handling with a single patient record, you eliminate three subscriptions and most of the data re-entry labor documented in Step 3.

This is the core architecture behind DentiVoice and the DentalBase platform. Calls, texts, and booking confirmations all feed the same patient timeline, and everything writes back to your PMS in real time. The consolidation is not just a cost saving — it is an operational improvement, because every team member starts every interaction informed. See our Software Stack Fragmentation Guide for the full breakdown of how a "Shared Brain" architecture works.

Underused tools. Pull usage data for every subscription. If a tool is used by only one person or was adopted for a project that ended, it is a candidate for elimination. Common culprits: a marketing dashboard nobody checks, a second scheduling widget that was tested and never removed, and a training platform that auto-renewed after onboarding.

Integration fees you are paying to connect tools that should not need connecting. If you pay a monthly fee for middleware that syncs your texting platform with your PMS, or a per-call charge for routing between your phone system and your answering service, those fees exist because your stack is fragmented. They disappear when the tools share a native platform.

What Consolidation Actually Looks Like

Most practices that complete this audit find the same cluster of overlap: a phone system, an answering service, a texting platform, and possibly a standalone AI receptionist — four tools doing versions of the same job, none sharing data with each other or writing back to the PMS.

DentiVoice replaces that cluster. It handles inbound calls the front desk can't answer, responds to missed calls via text, and books appointments directly into the PMS — Dentrix, Eaglesoft, Open Dental, or Curve Dental — with real-time write-back. No nightly batch sync. No manual entry. No second system to check.

Because it operates on a single patient timeline shared with the rest of the DentalBase platform, every call, text, and booking feeds the same context layer. When a patient who received a recall text calls back after hours, DentiVoice recognizes them, logs the interaction, and books the appointment. The front desk sees it in the PMS the next morning — already done.

For the audit spreadsheet, the math is simple: add up the monthly cost of your current phone system, answering service, and any standalone texting or AI tools. That's the line item DentiVoice consolidates. In most practices, the consolidation saves money on subscriptions and eliminates the staff time spent bridging those systems — the hidden cost from Step 3.

See the consolidation math for your practice.Book a free demo — we'll map your current stack, identify the overlap, and show you exactly what changes.

What the Audit Usually Reveals

"The practices that save the most money in a tech audit aren't the ones cutting tools — they're the ones consolidating," says Jordan, DentalBase's Head of Sales. "When you replace four disconnected subscriptions with one platform that handles calls, texts, scheduling, and attribution in a single patient timeline, the math works on day one."

Most owners who complete this process discover at least one tool nobody uses regularly, at least two tools that overlap in function, and significant staff time spent moving information between systems that should share it automatically. The fix isn't necessarily spending less — it's spending on tools that eliminate hidden costs rather than creating them.

Ready to run your audit?Book a free demo and we'll walk through your current stack, show you where the overlap is, and calculate the consolidation math for your practice.