IT problems in a dental practice are not measured in tickets. They are measured in chair time. A system that is down for forty minutes on a full day is a day that does not recover.
What follows is what we actually see, in order of how much disruption it causes.
1. Practice software that slows down as the day fills
What it looks like
The system is fine at 8am. By mid-morning, moving between patients takes several seconds. By afternoon, reception is apologising. Overnight it clears, and the next morning it is fine again — which is why it goes unreported for months.
What causes it
- Real-time antivirus scanning the practice database while it is in use
- Disk performance that was adequate at three chairs and is not at six
- A database that has grown for years without maintenance
- A server sized for office work rather than a busy clinical database
How to prevent it
Scoped antivirus exclusions for the database and imaging paths. Solid-state storage on anything serving the database. Scheduled database maintenance. None of these are expensive; they are simply not done by default.
2. Imaging that will not load when the patient is in the chair
What it looks like
An OPG takes twenty seconds to open. Intraoral images attach to the wrong record, or do not attach at all. A clinician is talking to a patient while a progress bar crawls.
What causes it
Imaging files are large and are requested at the worst possible moment. The usual causes are a saturated network link between the surgery and the server, imaging stored on slow disks, or a wireless connection doing work that should be wired.
How to prevent it
Wire the surgeries. Wireless is for tablets and guests, not for pulling radiographs mid-appointment. Keep imaging on fast storage, and check the link speed between where images live and where they are opened.
3. Backups that have never been restored
What it looks like
Nothing, until the day it matters. Then the restore fails, or produces a database that will not open, or turns out to be three weeks old.
What causes it
Backing up a database while it is running, without using the database engine or an application-aware snapshot. The job reports success. The output is unusable. This is the single most common serious fault we find when taking over a practice.
How to prevent it
- Use a backup method that produces a consistent copy of the database
- Keep a copy off site, and a copy that ransomware cannot reach
- Restore it — at least twice a year — and open the restored database
- Write down how long a full restore actually takes
That last point matters more than practices expect. "We have backups" and "we can be running again by lunchtime" are different claims, and only one of them is useful during an incident.
4. Email compromise
What it looks like
A staff member opens what appears to be a file share from a practice you know. Remote-control software installs behind a fake Windows update screen. Someone overseas reads the mailbox, takes saved passwords, and emails everyone in the address book.
What causes it
People, not software. These emails come from genuine addresses at practices whose accounts have been taken over. Antivirus does not stop it, because what installs is legitimate remote-access software. Link scanners return clean, because the site shows scanners a decoy page.
How to prevent it
Multi-factor authentication on every account, without exception. Staff who know the one rule: phone the sender before opening any unexpected shared-file link. And monitoring that watches what is running on your machines rather than only what arrives in the inbox.
This is live in Victoria right now. Our security advisory covers what the emails look like, how to check whether your practice has been affected, and what to do if someone has already clicked. It includes a printable poster for your front desk.
5. Hardware that fails without warning
What it looks like
A server that will not start on a Monday. A workstation in a surgery that dies mid-list. Usually the machine everyone knew was old.
What causes it
Equipment kept past its useful life because replacing it never becomes urgent — until it does. Practices routinely run seven-year-old servers holding every patient record they have.
How to prevent it
Keep a simple list of what you have, how old it is, and what happens if it stops. Replace the critical items on a plan rather than in an emergency. Emergency replacement always costs more, and it costs chair time as well as money.
The pattern underneath all five
None of these are exotic. Each one is well understood and preventable, and each becomes expensive only when nobody is watching for it.
The practices that avoid them are not the ones spending the most on IT. They are the ones whose provider knows what a practice management system needs, checks the things that fail quietly, and tests the backup before it is needed.
If you would like a second opinion on where your practice sits, we offer a free check across dental, medical and business clients in Victoria. The Australian Signals Directorate also publishes a practical baseline at cyber.gov.au, and the Australian Dental Association maintains guidance for practices.
Common questions
- Which of these five should we deal with first?
- Backups. Everything else costs you time. An unrecoverable backup can cost you the practice, and it is usually the cheapest of the five to fix.
- Our practice management software is slow. Do we need a new server?
- Often not. Antivirus exclusions and moving the database to solid-state storage resolve most cases. Replace hardware once you know it is actually the constraint.
- Is wireless good enough for our surgeries?
- Not for imaging. Wireless is fine for tablets, guests and administration, but pulling a radiograph mid-appointment should run over a wired connection.
- How often should we test a restore?
- At least twice a year, and after any significant change to the server or backup system. Record how long the full restore took — that number is what matters during an incident.
- Will antivirus protect us from phishing?
- Not from the attack currently moving through Victorian practices. What installs is legitimate remote-access software, so antivirus treats it as normal. Multi-factor authentication, staff awareness and monitoring are what work.
- How old is too old for a practice server?
- There is no single number, but past five years you should have a replacement plan rather than a hope. The relevant question is not the age — it is what happens to the practice on the day it does not start.
Not sure where your practice stands?
We will review your setup and tell you what we find. Twenty minutes, no obligation, no disruption to clinic hours.