ADSA 2026 gave our team something you just can’t get from a webinar or a market report: honest, face-to-face conversations with oral surgeons and practice administrators who had no reason to sugarcoat anything. No polished case studies. No carefully worded answers. Just real feedback from people who run specialty practices every single day and know exactly where the friction is.
We spoke with solo practitioners working 60-hour weeks, admins juggling multi-location headaches, and surgeons who have been on the same software platform for decades. And what came out of those conversations wasn’t just a list of complaints. It was a surprisingly clear picture of the same challenges showing up, practice after practice, regardless of size or location.
Here’s what we heard, and what it actually means for where OMS software needs to go.
Quick Summary
ADSA 2026 made one thing clear: OMS and specialty practices are tired of working around their software. The most common frustrations were disconnected imaging systems, notes workflows that eat up way too much of the surgeon’s day, referral management that’s still shockingly manual, and a real tension between staying on a server and exploring the cloud. Most practices aren’t asking for a revolution. They just want tools that stop making their teams do extra work.
Why ADSA 2026 Was a Reality Check for Specialty Dental Software
Trade show conversations can be pretty surface-level. A lot of “we’re exploring options” and “things are going well.” ADSA 2026 felt different. People weren’t talking about trends or innovation in the abstract. They were talking about their actual day. Specific frustrations. Specific workarounds. The kind of stuff that doesn’t make it into press releases.
A few themes came up so often that they stopped feeling like individual problems and started feeling like industry-wide gaps. Let’s walk through them.
Insight #1: Imaging Disconnection Is Still a Real, Daily Problem
Honestly, this one surprised us with how often it came up. Practice after practice described workflows where their imaging system has no bridge to their practice management software. So what happens? Staff manually copy and paste X-rays. Screenshots. Copy. Paste. For every single patient.
At one multi-location practice, the problem was even more frustrating. The 3D imaging captured at one office was completely invisible to staff at another location because each site ran its own separate imaging server. So if a patient had a CBCT done at Location A and showed up for surgery at Location B, the surgical team was either going in blind or burning time on workarounds.
That’s not just inefficient. For an OMS practice doing implant consultations or complex surgical planning, being able to pull up a high-quality 3D scan in the room during a consult is a real part of the conversation. When that isn’t possible, it shows. And it affects case acceptance.
The solution conceptually isn’t complicated: a true, native imaging bridge. The frustrating part is that so many practices still don’t have one in 2026.
Insight #2: Documentation Is Eating the Surgeon’s Day
“Spends a lot of time on notes.” We heard that phrase, almost word for word, from multiple people at ADSA 2026. Some were on platforms they described generously as “old school.” Others had staff doing essentially all the note-writing after each appointment, turning surgical documentation into a whole separate job. One attendee mentioned their partner prefers to dictate because typing is slow, and they’d tried several third-party dictation tools without finding anything that actually worked cleanly.
Here’s the thing: documentation isn’t going away. Surgical notes matter clinically and legally, and they should. But when a surgeon is spending a significant chunk of every day just trying to get notes done, something in the workflow is off.
The specialty needs notes tools that are built into the system, not bolted on as an afterthought. Staff shouldn’t be transcribing. Surgeons shouldn’t be fighting with dictation software that doesn’t understand clinical terminology. This should be a solved problem by now.
Insight #3: Referral Management Is Still Surprisingly Manual
Oral surgery is a referral-based specialty. That’s not a nuance, it’s the core of the business model. So you’d think that referral management would be a central, well-developed feature in any software built for OMS. And yet, at ADSA 2026, we kept hearing the opposite.
One attendee using a GP-focused platform said outright that they specifically wanted software designed for referral-based practices because what they had didn’t come close. Another described spending a frustrating amount of time on referral letters, a task that should take a few minutes, not a meaningful chunk of the workday.
Someone else mentioned they couldn’t even generate referral letters in their current system after switching to it. For an OMS practice with a high GP referral volume, that’s not a small gap.
The referral loop matters from start to finish: receiving the referral, scheduling, treating, documenting, communicating back to the referring GP, and maintaining that relationship so the next patient follows. If software only handles part of that loop, the rest gets done manually. And manual processes don’t hold up as a practice grows.
Insight #4: The Server vs. Cloud Conversation Is a Lot More Nuanced Than Vendors Often Make It
The cloud gets pushed pretty hard at conferences like this. And it does have genuine advantages, especially for multi-location practices or anyone trying to solve the imaging access problem we talked about above. But what we actually heard at ADSA 2026 was more complicated than “cloud is obviously better.”
A lot of the attendees we spoke with were not ready to move, and they had completely legitimate reasons. One rural practice was upfront about connectivity limitations. Another had just dropped serious money on a new server and wasn’t interested in reversing course. Someone else was still working through a cost analysis and admitted they didn’t have a full picture of what the cloud would actually cost them month to month.
That’s all reasonable. Cloud readiness is a spectrum, not a light switch. A practice needs to look at both sides of the math, including hardware costs, IT support, internet reliability, and monthly subscription fees, before making a decision that’s right for their situation.
| Factor | Server-Based | Cloud-Based |
|---|---|---|
| Upfront Cost | Higher (hardware investment) | Lower (subscription model) |
| Monthly Cost | Lower after hardware is paid off | Predictable recurring fee |
| IT Maintenance | Practice is responsible | Vendor managed |
| Multi-Location Access | Requires VPN or remote setup | Native access from anywhere |
| Imaging Access Across Sites | Often siloed by location | Centralized and accessible |
| Internet Dependency | Minimal | High |
| Disaster Recovery | Practice managed | Vendor managed |
| Upgrade Cycle | Manual, periodic | Continuous, automatic |
There’s no universal right answer here. The right answer depends on your practice size, your current infrastructure, and honestly, how comfortable your team is with change. What matters is going into that conversation with accurate information.
Insight #5: Implant Inventory and Fee Schedule Gaps Are Quietly Slowing Practices Down
These two topics don’t get as much airtime as imaging or notes, but they came up at ADSA 2026 and they’re worth talking about.
On the inventory side: one practice mentioned that their implant tracking system wasn’t really working for them. For a high-volume implant practice, that’s more than an annoyance. If you can’t reliably track what’s on hand, you’re either over-ordering and tying up cash, or you’re scrambling before a case. Neither is great.
On the fee schedule side: at least one practice described their front office team manually calculating fee schedules. In 2026. That’s exactly the kind of repetitive, error-prone administrative task that should have been automated years ago. It’s a small thing on its own, but small things add up. Every hour spent doing manual math is an hour not spent on patient care or case coordination.
Insight #6: AI Interest Is Real, but So Is the Skepticism
AI in clinical documentation came up more than once at ADSA 2026, and the response was pretty consistent: genuine curiosity, paired with genuine caution. More than one person said they were interested but not ready for a major investment yet.
That’s actually a healthy place to be. AI documentation tools are still maturing, and not all of them are built with surgical workflows in mind. The right question to ask isn’t “does it use AI?” It’s “does the AI output actually save my team time, or does it just create a new thing to review and fix?”
For OMS specifically, the bar is high. Surgical note AI needs to understand procedure-specific terminology, generate clinically accurate documentation, and fit into the way the team already works. If a surgeon is spending as much time correcting AI-generated notes as they would have spent writing them, the tool isn’t doing its job yet.
The practices that approach AI carefully and evaluate it against their actual workflow, rather than buying the pitch, are going to get a lot more out of it when the right solution comes along.
The Contrarian Take: New Software Won’t Fix a Broken Workflow
Here’s something worth saying plainly, even if it’s not what people want to hear at a software conference: switching practice management platforms will not fix a broken internal process. It will change the tools. It won’t change the habits, the communication patterns, or the underlying workflow issues that were causing problems in the first place.
The practices that get the most out of a software transition are the ones that do the internal work first. They map out how referrals actually move through the office. They document who touches notes and when. They understand their imaging workflow from capture to the consult room. They run the real cost analysis on server vs. cloud before anyone tells them which one to choose.
Good software makes a good process run better. It’s not a substitute for having the process figured out.
That said, some of the systems we heard about at ADSA 2026 have real gaps that no amount of workarounds can cover. When the tool itself is the problem, changing it is the right call. But going in with realistic expectations, and a clear picture of what the transition actually involves, is what separates a successful switch from a painful one.
What ADSA 2026 Tells Us About Where the OMS Market Is Heading
The clearest takeaway from ADSA 2026 is this: OMS practices are done accepting software that was built for general dentistry and patched together for surgical use. The specialty has specific needs, specific workflows, and specific clinical requirements that generic platforms consistently fall short on.
The referral loop, the imaging pipeline, the documentation complexity, the implant inventory, the claims and billing nuances for surgical procedures, these aren’t edge cases. They’re the daily reality of running an oral surgery practice. Software that treats them as afterthoughts creates friction that compounds over time.
The practices that are going to be in the strongest position over the next few years are the ones that demand tools built specifically for what they do. And the software companies that earn their trust will be the ones that show up to conversations like ADSA 2026, actually listen, and build products that reflect what they hear.
FAQ
How realistic is it to actually switch OMS software after using the same system for 10 or 15 years?
It’s absolutely doable, but it requires more planning than most people expect going in. The big challenges are data migration, getting staff retrained without disrupting daily operations, and rebuilding workflows inside a new system. Practices that take time to plan the transition carefully, including a period where both systems run in parallel and dedicated training time for the team, consistently have smoother outcomes. The most important thing is getting honest, detailed information about what migration actually involves before committing.
What’s the real cost comparison between staying on a server and moving to the cloud for a single-doctor practice?
It depends on a few variables: how old your current hardware is, what you’re paying for IT support, and how reliable your internet connection is. A new server can run $20,000 to $30,000 or more when you factor in setup and configuration, plus ongoing maintenance costs. Cloud subscriptions are a recurring expense, but they typically include updates, managed backups, and better disaster recovery. If you just refreshed your server hardware, staying put probably makes financial sense for a few more years. If you’re approaching the point where you’d need to replace hardware anyway, the cloud comparison gets a lot closer.
Does not having a native imaging bridge actually affect case acceptance, or is it just a workflow inconvenience?
It’s both, and the case acceptance piece often gets underestimated. The workflow hit is obvious: staff manually copying and pasting imaging wastes time and introduces the possibility of error. But the clinical conversation piece matters too. When a surgeon can pull up a patient’s CBCT and walk through it with them in real time during a consult, the treatment plan becomes tangible in a way that a verbal explanation or a printout can’t replicate. Practices that have seamless imaging access consistently report that complex cases are easier to present and that patients move forward with treatment more confidently.
Is AI-assisted note documentation actually ready for OMS use, or is it still too early?
It depends on how it’s built. General-purpose AI documentation tools often aren’t well-suited for surgical use. Purpose-built tools trained on OMS-specific language and procedure types are further along and more useful in a clinical setting. The best way to evaluate any AI documentation tool is simple: time how long it takes to review and correct the output. If the review takes as long as writing the note from scratch would have, the tool isn’t saving anyone anything. The value is real when it’s working well. The key is evaluating it honestly against your actual workflow before committing.
How should referral letter generation work in a high-volume OMS practice?
The goal is templated, auto-populated letters that pull directly from the clinical record. The surgeon reviews, makes any adjustments, and sends. That’s it. Staff shouldn’t be drafting letters from scratch after every appointment, and surgeons definitely shouldn’t be doing it. If your current system requires either of those things, referral letter capability should be near the top of your list when evaluating new software options.
What questions should a practice ask a software vendor before committing to a switch?
A few that matter: What does the data migration process actually look like, and what’s your role in it? What are realistic timelines for getting fully operational in the new system? What does support look like after the first 90 days, not just during onboarding? And how does pricing change over time as the practice grows? Beyond what the vendor says, it’s worth finding current customers of similar size and setup and asking them directly how things have gone. That conversation will tell you more than any demo.
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