UK dental practices run on a small number of practice management systems, with Exact (Software of Excellence/SOE) and Carestream R4 dominating legacy installations, and Dentally growing as the most-adopted cloud alternative. The choice matters beyond features: Exact has a documented history of data export restrictions that make switching difficult, R4 migration is more straightforward, and the newer cloud systems (Dentally, Pabau) offer pricing transparency that the legacy platforms do not.
Exact is one of the two most widely installed dental PMS in UK practices. Software of Excellence is a Carestream subsidiary (itself part of the broader Henry Schein ecosystem). The platform covers clinical records, treatment planning, NHS claiming via WebEDI, patient recall, and imaging integration.
Pricing is not publicly disclosed — practices are quoted individually based on size and module selection. The more significant concern reported by practices is data portability. Exact has been criticised for restricting data exports — making it difficult for practices to migrate to a different system without losing patient history or paying for proprietary export tools. For a practice considering switching, the question of what patient data they can extract and in what format is as important as the cost of the new system.
R4 is the other dominant legacy system. It is actively maintained with current NHS claiming support — including NHS Wales FP17 integration via Patient Bridge, hosted on Microsoft Azure UK with NHS accreditation. Practices report that data migration out of R4 is more straightforward than from Exact, which is relevant for practices considering moving to a cloud system.
Like Exact, R4 pricing is not publicly disclosed.
Dentally is the most significant cloud-based challenger to the legacy systems. Over 12,000 UK practices use Dentally. Published pricing in three tiers:
Dentally is browser-based, accessible over 4G, and supports scheduling, patient recalls, automated appointment reminders via SMS and email, and WebEDI for NHS claiming. The cloud architecture means no local server is required and remote access is standard — relevant for practices with multiple sites or peripatetic associates.
For practices currently on Exact or R4, the lower pricing and published cost structure of Dentally make it an appealing alternative on economics alone. The migration question — what Dentally's import tools can accept from the incumbent system — is the key practical consideration before committing.
iSmile covers the core practice management functions: appointment scheduling, treatment planning, recall automation, patient portal with online booking, SMS/email marketing, and X-ray integration (included without charge). A multi-step automated recall manager is built in. Pricing is not publicly listed; a free trial is available. iSmile suits practices that want recall automation and patient communication features built directly into the PMS rather than via third-party tools.
Pabau is an AI-powered multi-purpose platform serving dental, medical spa, and clinic markets. Published pricing from $62 per month (single user, 100 patients). All tiers include unlimited patients. Features include online booking via Google Business Profile integration (Book Online button), clinical records, treatment plan acceptance, payments, and marketing automation. Pabau's multi-discipline design means it suits practices that also offer aesthetics or other clinical services alongside dentistry.
| Product | Published pricing | Deployment | NHS claiming | Data portability |
|---|---|---|---|---|
| Exact (SOE) | No — quote only | On-premise/cloud | Yes (WebEDI) | Reported restrictions — check before committing |
| Carestream R4 | No — quote only | On-premise/Patient Bridge cloud | Yes (WebEDI + Wales) | More straightforward than Exact |
| Dentally | £50–£108/month (published) | Cloud | Yes (WebEDI) | Standard data export |
| iSmile | No — free trial | Cloud | Yes | Not publicly specified |
| Pabau | From $62/month (published) | Cloud | Yes | Standard export |
The dental software market has a specific problem with patient data portability that other sectors do not face to the same degree. Patient records in dentistry include clinical charting, treatment history, medical histories, and imaging — structured data that does not export cleanly from every system. Practices that discover their current system restricts or charges for data exports when they try to switch face a genuine problem: rebuilding patient records manually is impractical for even a modest-sized practice.
Before signing any dental software contract, practices should clarify in writing: what patient data can be exported, in what format, at no additional charge, and whether that export includes clinical charts and images as well as demographic data. This is especially important with Exact/SOE where data export restrictions have been a documented issue in practitioner forums.
All the platforms above support automated recall, but with different channel approaches. SMS has a 98% open rate versus approximately 20% for email. A practice whose recall system sends email reminders only is getting a fraction of the recall response it would achieve with SMS.
iSmile's recall manager is specifically marketed around multi-step recall sequences — automated campaigns that move patients through SMS, email, and postal contact at defined intervals. Dentally and Pabau both include automated reminder workflows. For practices whose recall rate is a revenue issue, comparing the recall automation depth of systems on shortlist is as important as comparing the NHS claiming features.