Open-Source EHR Systems: Can a Dental Clinic Use Them?

This guide is for dentists, practice managers and clinic IT staff who searched for “open source EHR” or “dental practice management software free” and keep running into names like OSCAR EMR, GNUmed and Elexis. The short answer: a dental clinic can run one of these systems, but none of them is dental software. None has an odontogram, a periodontal chart, dental procedure codes or a link to your X-ray software. Three are actively maintained (GNUmed, Elexis and EHRbase); three are dormant or past end of maintenance (OSCAR 19, LibreHealth EHR and NOSH ChartingSystem).

Where they genuinely help is the medical side of a dental record: medical history, medications, allergies, letters and documents, or, in the case of EHRbase, a standards-based data store for a school or research project. Every program below has a free, open-source licence. “Free” describes the licence only: the server, setup, backups and security remain your cost and your responsibility.

The short list

GNUmed

GNUmed is the most practical choice here for a small practice that wants a self-hosted medical record. It uses a PostgreSQL server with a desktop client for Linux, Windows and macOS. Version 1.8.25 was released on 6 September 2026, and a 1.9 branch is in release-candidate testing. For a dental team its strengths are the document archive (intraoral photos, exported radiographs, referral PDFs), visual progress notes drawn on your own image templates, and consent or referral letters filled from patient data. A tooth diagram annotated this way is still a picture, not tooth data you can query. Limits: no dental codes, basic invoicing, a manual install on Windows and Mac, and community-only support. Pick it if someone on your team is comfortable running PostgreSQL.

Elexis

Elexis is open-source practice software for Swiss medical practices. It is maintained: version 3.13 is needed for TARDOC billing from 1 January 2026, although the ready-made packages on the project’s GitHub page are still 3.12 from August 2024. Records are organised by patient, case and consultation, with lab findings, prescriptions, letters and Swiss medical billing. There is no “dental fork”, no tooth chart and no Swiss dental tariff in its documentation. Its realistic dental use is narrow: an oral-surgery or mixed practice in Switzerland keeping the medical side in Elexis and dental charting in a dental system. The community and most documentation are German-speaking, and the project advises having an official supporter install it. Outside Switzerland, GNUmed is the better fit.

EHRbase

EHRbase is a different kind of product: an openEHR clinical data repository, not an application for the front desk or the chair. It stores structured records, exposes the openEHR REST API and answers queries in the Archetype Query Language (AQL). It is developed by vitasystems (vitagroup) and the Peter L. Reichertz Institute for Medical Informatics; version 2.36.0 appeared on 15 September 2026. There is no user interface and no dental template set. A dental school, registry or research group could model a dental data set from openEHR archetypes, upload it as a template and build a front end on top. Current builds need Java 25 and PostgreSQL 15 or newer. Choose it only if you have developers with openEHR modelling skills.

OSCAR EMR

OSCAR EMR is the name most people search for: a web EMR from McMaster University’s Department of Family Medicine, built for Canadian primary care with provincial billing, eForms, prescribing and HL7 lab import. For a new installation its status matters more than its features. On 26 August 2026 the OSCAR community site announced the end of maintenance for OSCAR 19, warned of unfixed security issues and named CARLOS EMR, an open-source successor still in alpha, as the replacement. OSCAR Pro is a separate commercial product from WELLSTAR (WELL Health) and is neither open source nor dental. A community health centre that already runs OSCAR can give its dental team access to medical history and consult notes; do not start a new dental deployment on OSCAR 19.

LibreHealth EHR

LibreHealth EHR is a web EHR and practice-management system forked from OpenEMR, with a calendar, patient flow board, encounter forms, a layout-based form editor and billing tools aimed at US medical claims. It is dormant: the last release, 2.0.0, dates from November 2017, and the repositories show no meaningful activity since 2023. The code targets PHP 7.x, which no longer receives security fixes. You can build a text-based dental exam form with the layout editor, but it will never be a chart. Use it to teach health-IT students or to study how an EHR is put together, on fictitious data only. For real patients, choose a maintained system.

NOSH ChartingSystem

NOSH ChartingSystem is a web EHR written by family physician Michael Chen. NOSH 3 is a FHIR-native Progressive Web App run in Docker, with encryption at rest in CouchDB, passwordless sign-in and FHIR endpoints for conditions, medications, allergies and immunisations. It is dormant: there are no tagged releases, and the last code update was on 30 March 2025. The NOSH 3 documentation does not describe scheduling or billing. For dentistry it is a teaching and prototyping tool, useful for showing how a dental system could read a structured medical history over FHIR. It is a single-maintainer project with no commercial support, so keep real patient data out of it.

What a dental practice would have to add

Before anyone suggests “we will just customise GNUmed”, list what a working dental record needs and none of these six provides:

• Tooth chart. An odontogram with tooth numbering, surfaces, existing restorations and planned treatment. Here you can only approximate it with an annotated image (GNUmed) or free-text fields (LibreHealth layout forms).
• Periodontal chart. Pocket depths, recession, bleeding and mobility per site, compared between visits.
• Dental codes and claims. The procedure codes and claim formats your country and insurers use. The billing in these systems is built for medical tariffs in Canada, Switzerland or the US.
• Imaging link. A bridge from the patient record to your intraoral sensor, panoramic and CBCT software. GNUmed can look up studies on an external DICOM server; the others have no imaging link.
• Treatment plans and recall. Multi-visit plans with phases and estimates, plus hygiene recall scheduling.

Building these is a software project, not configuration. The realistic pattern is dedicated dental practice-management software for charting and billing, with an open-source medical record used only where a medical team already works with one. Note also that Open Dental, the dental system many people remember as open source, changed its licence from GPL to proprietary in version 24.4, so it no longer belongs on an open-source list.

Data security and hosting basics

With open-source clinical software you are the hosting provider. The privacy law that applies to your practice (for example HIPAA in the US or GDPR in Europe) applies in full, whatever licence the software carries. The minimum:

• Keep the server off the open internet. Use HTTPS with a proper certificate and remote access through a VPN. OSCAR, for example, is served over HTTPS on port 8443.
• Change default logins on day one. OSCAR installs with a demo login, and EHRbase’s Basic authentication ships with documented default user names and passwords.
• Encrypt disks. The OSCAR installation guide recommends full-disk encryption; apply the same rule to any server and backup drive holding patient data.
• Back up and test restores. GNUmed and EHRbase run on PostgreSQL, OSCAR and LibreHealth on MariaDB or MySQL. Take automated, encrypted, off-site backups and restore one to a test machine regularly.
• Patch everything. Operating system, database, Java or PHP, and the application. A dormant project cannot be patched upstream, which is the main reason to avoid OSCAR 19, LibreHealth and NOSH for real patients.
• Keep test and live data apart. Never enter real patients on GNUmed’s public test database or the EHRbase sandbox.
• Use roles and audit. Give each user their own account; GNUmed audits multi-user access and LibreHealth has role-based access control and an audit log viewer.

How to choose

1. Write down what you need. If the answer is tooth charting, perio charting and dental claims, you need dental practice-management software, not any of these.
2. If you also need a medical record (oral surgery, hospital dentistry, a community health centre), choose GNUmed internationally or Elexis in Switzerland.
3. If you already run OSCAR 19, plan a migration now; the community names CARLOS EMR as the successor.
4. If you are building an application, a teaching platform or a research registry, evaluate EHRbase.
5. For health-informatics teaching only, LibreHealth EHR and NOSH are acceptable on fictitious data.
6. Name the person who will run the server, backups and updates. If nobody can, stop here.
7. Test with fictitious data first: GNUmed’s public test database, the Elexis demo database or the EHRbase sandbox.

FAQ

Is there a free open-source EHR with dental charting?

Not among these six. None has an odontogram, a periodontal chart or dental procedure codes, and no official dental add-on exists for any of them.

Can a dental office use OSCAR EMR?

Only for medical history and consult notes where a clinic already runs it. OSCAR 19 reached end of maintenance in August 2026, so it is not a sound base for a new installation.

Which open-source EHR is still maintained?

GNUmed (1.8.25, September 2026), Elexis (3.13, 2026) and EHRbase (2.36.0, September 2026). LibreHealth EHR and NOSH ChartingSystem are dormant.

Is there an Elexis version for dentists?

No. Elexis is Swiss medical practice software; there is no dental fork, tooth chart or dental tariff.

Is free dental practice management software really free?

The licence may be free, but the server, installation, backups, security updates and support are not. Budget for the person or company who will run the system.

GNUmed or OSCAR EMR: which is better for a small clinic?

For a new installation, GNUmed, because it is actively maintained. OSCAR is browser-based and built around Canadian billing, but OSCAR 19 is no longer maintained.

Last updated: 29 September 2026 · SoftProDents editorial team. Licence, version and platform details are checked against each developer's official documentation; none of the tools listed here should be treated as a certified medical device unless its vendor says so.