What is the single most important question to ask an AI dental scribe vendor?

Ask them to open a test patient in your actual PMS and show the finished note sitting in the chart. Not a slide, not a video — a live screen share into a sandbox of the system you run. Some products stop at generating text you copy and paste, which is a text generator rather than a documentation system. If a vendor cannot show the note landing in the chart on the first call, every other question is academic.

How do I check whether an AI scribe is authorized to write to my PMS?

Open Dental and Henry Schein One both publish public vendor lists. Open Dental's third-party list uses trust tiers: Authorized (87 vendors), Authorized In Transition (11), Dangerous/Unknown (22, which is where direct database access or unwhitelisted plugins land), Not Currently Active (11), plus 14 Native Integrations. Listing is free — vendors request it at vendor.relations@opendental.com. Henry Schein One's API Exchange publishes its own list for Dentrix Ascend and requires SOC 2 Type II and OAuth 2.0. Look at both before your sales call.

Does an AI scribe file the note under the right provider?

It depends on the PMS, and this is where vendors get vague. Dentrix Ascend has a real provider field, so notes can be filed against a provider as structured data. An Open Dental commlog has no provider field at all, so the best available approach is writing the provider's name into the note body. Ask which field specifically — "fully attributed" is not an answer.

What should a vendor say about audio retention?

A good answer names systems and durations: for example, dictation audio held in memory only, never written to disk or object storage, with transcript text kept 24 hours so an interrupted recording can be resumed or a finished dictation continued. Scope matters too — a product can have a dictation path that never persists audio and a separate opt-in, consent-gated recording feature that uploads audio to storage. An unqualified "we never store audio" covering an entire product line deserves a follow-up question.

Can a signed clinical note be edited after the fact?

It should not be. Once a note is signed, corrections belong in a dated addendum filed against the original, with both versions retained and visible. If a vendor's system can silently rewrite a signed entry, your chart stops functioning as a legal record. Ask specifically what the audit trail captures — generated, reviewed, approved, synced — and whether you can export it.

What happens to my notes if I cancel the contract?

Notes already written into your PMS stay, because they are in your chart. The question is everything held only in the vendor's system: transcripts, unapproved drafts, audit logs. Ask whether you can export it, in what format, and for how long after termination the export remains available. Also ask about term length — a twelve-month commitment signed before you have seen a note in your chart is not reasonable.

AI Dental Scribe Buying Guide: The Questions to Ask Before You Sign

Every AI scribe demo works. That is the problem.

The rep dictates a clean two-minute composite on a quiet laptop, the note appears, everyone nods. Nothing in that demo tells you what happens at 4:40pm when the recording gets interrupted by a hygiene check, the note has to land under the right provider on the right date, and someone has to explain to an auditor why a signed entry changed.

This is the list of questions I actually use. They are organized by theme, and for each one I’ve written what a good answer sounds like and what an evasive one sounds like. Evasive is not the same as bad — sometimes the honest answer is “we don’t do that yet.” A vendor who says that is more trustworthy than one who says “yes, fully integrated” and means a browser extension that pastes text.

Before anything else: one question that sorts the field

“Open a test patient in my PMS and show me the finished note sitting in the chart.”

Not a slide of a chart. Not a video. A screen share into a sandbox of the system I actually run.

Some products stop at “here is your note, copy it.” That is a text generator, not a documentation system, and it should be priced like one. If they can’t show the note in the chart in the first call, everything below is academic.

Integration: does the note reach the chart, under whom, on what date

Ask: do you write through the PMS’s official API, or through the database / a browser plugin / a person?

This is a governance question, not a plumbing question. Open Dental publishes a public third-party vendor list with explicit trust tiers. As published, it lists 87 vendors as Authorized, 11 as Authorized In Transition, 22 as Dangerous/Unknown — the tier for direct database access and unwhitelisted plugins — 11 as Not Currently Active, plus 14 Native Integrations. Listing is free; vendors request it through vendor.relations@opendental.com, so a vendor who isn’t on it chose not to be, or couldn’t be. Go look for yourself before your call and check the tier your vendor sits in. It takes ninety seconds and it changes the tone of the conversation.

Open Dental is not the only one doing this. Henry Schein One’s API Exchange also publishes a public vendor list for its integrations, and requires SOC 2 Type II and OAuth 2.0. Ask which listing the vendor appears under, by name, and then confirm it yourself.

Ask: which provider is the note filed under, and how is that stored?

This is where you’ll learn whether the vendor knows their own integration. Attribution is not uniform across systems. Dentrix Ascend has a real provider field, so a note can be filed against a provider as structured data. An Open Dental commlog does not have a provider field at all — so the best any vendor can do there is write the provider’s name into the body of the note itself. That distinction matters for associate productivity reporting and for anything downstream that filters by provider.

We build a scribe ourselves, and this is exactly how our Open Dental notes behave — name in the note text, because the field doesn’t exist. I’d rather say that plainly than let a buyer discover it in month three.

Good answer: “Ascend, structured provider field. Open Dental, name in the note body, because commlogs have no provider column.” Evasive answer: “It’s fully attributed to the treating provider.” (Fully attributed how? In which field?)

Ask: what date does the note carry, and what happens when the write fails?

Notes should date to the visit, not to the moment the AI finished. And writes do fail — the PMS is down, the eConnector is stopped, the token expired. Ask whether failures retry, whether anyone is told, and whether the note is still recoverable in their system afterward. “It just works” is not an answer to a failure-mode question.

Ask: what else does this integration already cover? If you’re going to authorize a vendor to write to your chart, it is worth knowing whether the same connection can carry intake forms, eligibility verification with writeback, treatment plans, or payment posting — or whether you’ll be authorizing four more vendors to do those. Ask per PMS, too: what a vendor supports on one system is not automatically supported on another.

Privacy: audio, training, BAA, subcontractors

Ask: is the audio stored? Where, and for how long?

Push for a sentence that names a system. “Dictation audio held in memory only, never written to disk or object storage; transcript text retained 24 hours so an interrupted recording can be resumed” is an answer. “Encrypted in transit and at rest” is a deflection dressed as a spec — everything is encrypted at rest; that tells you nothing about retention.

Also scope the answer. A product may have a dictation path that never persists audio and a separate, opt-in, consent-gated recording feature that uploads audio to storage. Those are different retention stories and a careful vendor will distinguish them. A vendor who says “we never store audio” about their entire product line, without qualification, either hasn’t read their own architecture or is rounding off in their own favor.

Ours works exactly that way, and I’ll state it here rather than make you go hunting: in our dictation feature, the audio lives in memory and is never written to disk, S3, or a database; the transcript text is kept for 24 hours, so an interrupted recording can be resumed or a finished dictation continued inside that window. Separate opt-in, consent-gated recording features do upload audio to storage. Two features, two answers.

Ask: do you train models on my patients’ data? Is that the default, and can I turn it off in writing?

Good answer: “No, and here’s the contract clause.” Evasive answer: “We use de-identified data to improve the product.” De-identified by whose standard, reviewed by whom?

Ask: when do you sign the BAA — before or after the pilot? Before. Always before any real patient data moves. A pilot on live patients without an executed BAA is a risk you’re taking on personally.

Ask: name your subcontractors. Which LLM provider, which transcription engine, which cloud, which country. Every one of them is a downstream BAA and every one is part of your risk surface. A vendor who won’t name their model provider is telling you something.

Reliability: the boring failures that actually happen

The recording is interrupted mid-visit. Does the partial transcript survive, or do you start over? Can a finished dictation be reopened and continued a few minutes later, or is it sealed the moment you stop?
The internet drops. Does the app buffer locally and recover, or lose the appointment?
The visit runs 50 minutes. Ask for their real ceiling — a maximum recording length, and what happens to quality as you approach it. Vendors rarely volunteer either number.
The operatory is loud. Suction, compressor, a crying six-year-old. Ask to record your own thirty seconds of a real op during the demo.

Good answer: specific behavior with a number attached. Evasive answer: “That hasn’t been an issue for our customers.”

Clinical governance: signing, amending, audit trail

Ask: after a note is signed, can it be edited?

The correct answer is no. Corrections should file as a dated addendum against the original, with both versions retained. If a vendor can silently rewrite a signed note, your chart is not a legal record — it’s a wiki.

Ask: what does the review step look like before signing? Assume you will be editing. A study published in JMIR Medical Informatics reviewed AI-generated clinical documentation — 7,545 notes, 356 of them evaluated in detail — and found omissions in 18%, hallucinations in 11.5%, and accidental inclusions in 9.3%. Those are medical notes, not dental, but the failure modes are the same ones you’ll be reading for. A product that makes review fast is worth more than one that claims not to need it.

Ask: what does the audit trail capture, and can I export it? Who generated, who reviewed, who approved, who synced, timestamps for each. And note that approved and written to the chart are two different events. Ask which of the two their dashboard is actually showing you, because “notes completed” often means the first one.

Commercial: pricing, term, and what happens to your notes if you leave

Per-provider or per-practice? In a three-doctor, four-hygienist office those two models produce very different bills. Do the arithmetic on your own roster before the call, and ask whether hygiene counts as a seat.

Contract length and ramp. Month-to-month after a short pilot is reasonable. A twelve-month term signed before you’ve seen a note in your chart is not.

Exit. If you cancel, do the notes already written to your PMS stay? (They should — they’re in your chart.) What about anything held only in their system: transcripts, drafts, audit logs? Can you export it, in what format, and for how long after termination?

Total stack cost, not scribe cost. Open Dental sells its own eServices bundle at roughly $165/month — Web Forms, Patient Portal, eReminders, eConfirmations, Integrated Texting, Web Sched. Open Dental has no first-party AI scribe (Bola AI is a native partner, not their product), so a scribe is genuinely additive there. But if a scribe vendor is also selling you forms and reminders, check what you’re already paying for twice.

The short version

If a vendor answers four questions concretely — which PMS field the provider name lands in, how long audio is retained, what happens to an interrupted recording, and whether a signed note can be edited — they’ve done the engineering. If all four come back as adjectives, they’ve done the marketing.