Quick Answer

Most Open Dental security gaps don't come from offices skipping setup. They come from settings that got explained once during conversion and never revisited. To protect your audit trail, relock your global lock date every month, set auto logoff to somewhere between 5 and 15 minutes, keep your Admin user group down to one or two people, and give every single user their own login and strong password. That's how you know, with certainty, who did what in your database.

Your Computer Isn't Locked. Neither Is Your Audit Trail.

I've been helping out with some of our Comp Exam projects recently and am finally completing them mostly on my own now. But there's a pattern I keep running into that it doesn't look like anybody really talks about until someone like me shows up and starts asking questions.

The most recent one... an office where the Admin User Group had a dozen people in it.

A dozen. Not one or two people who genuinely need full access. Twelve.

When I first saw that, my gut reaction was something like, okay, that's a lot, but surely there's a reason. Maybe it's a big practice. Maybe everyone really does need that level of access for some workflow I'm not seeing yet. But the more Comp Exams I do, the more I'm realizing this isn't really an exception. It's closer to the norm than I expected, and that's the part that's been sitting with me.

Here's the thing I learned that has changed how I think about it though... These offices weren't operating in the dark on security settings. If they had been, you wouldn't see this many different User Groups, or this many people sorted into them in ways that don't quite make sense. Someone, at some point, probably during conversion, sat down and explained what the global lock does, what auto logoff means, how user groups are supposed to work.

What didn't happen is anyone explaining why it mattered. And without the why, none of it gets revisited. It just sits there, set once and forgotten, while the practice grows and more people get added wherever seems convenient at the time.

That's the whole reason comp exams exist, honestly. Before we ever talk about training, RCM work, or any kind of optimization, we're looking at what's actually happening in your database right now. Security is one of the first things we check, and it's also one of the things I think gets the least attention from offices themselves, because it's invisible.... until it isn't.

So here's what we're actually looking at in Open Dental when we open up Setup > Security.

The Global Lock

In the top left of the Security window, there's a Global Security Settings button which has a Global Lock section at the bottom. This should be relocked every single month as part of your end of month process. Not once a year. Not "whenever someone remembers." Monthly.

I've seen offices with a lock date from over a year ago. Some go even longer than that. What that means, practically, is that the entire financial history of that database can be edited at any time, retroactively, by anyone with the right access. Nothing stops a payment from being adjusted three months after the fact. Nothing stops a procedure from quietly changing. Your books just... stay open. Forever.

Auto Logoff

A lot of offices have this feature turned off entirely, which means if you walk away from your computer, no matter how long you're gone, your user stays logged into Open Dental. If someone else sits down while you're away, anything they do shows up as you. Not as them. You.

We generally recommend somewhere between 5 and 15 minutes of non-use for automatic logoff, depending on the workflow of the office.

And to be clear, this isn't about not trusting your team. Most of the time there's nothing nefarious happening at all. It's more likely that another team member just needs to do something quick, grab a chart, make a note, whatever, and your workstation is the closest open one. They sit down, do the thing, and move on without thinking to log you out and log themselves in first. Maybe they didn't mean anything by it. But now whatever they did is sitting under your name, and the audit trail no longer reflects who actually did what.

At a previous job, my managers tried to drill this into the employees in a way I still think about. If they caught you walking away from your computer without locking it, they'd hop on while you were gone and flip your screen completely upside down. No warning. You'd come back from the bathroom or grabbing a snack, and suddenly you're looking around at your team feeling pretty embarrassed while trying to figure out how to flip it back.

It sounds funny written out like that, but it worked, because it made one thing very obvious. Someone had been on your computer. They couldn't have changed that setting without first being logged in as you. That's the entire point of an audit trail, and it's the entire risk when auto logoff is disabled. Anyone can become you for as long as you're away, and there's not usually an upside-down monitor to tip you off in real life.

User Groups

Generally, we recommend keeping this simple. Three groups. Admin, Providers, and Regular Users.

Admin should really be one person at your practice, maybe two if there's a strong reason for it. Providers cover your doctors and hygienists. Regular users cover everyone else, front office, billing, whoever else is working in the system day to day.

You can get more specific than that if your practice wants to limit permissions to even more specific workflows, but what you don't want, which I keep finding, is doctors, plus ten other people who have no real reason to be there, all sitting in the admin group because it was just easier at the time.

To be clear, when we come in to do a Comp Exam, we do ask for temporary admin access ourselves, because we need to be able to see everything and test that it's actually working. That's a limited-time, specific-purpose situation. It's not the same as a dozen permanent staff members carrying access they don't use and probably don't need.

Passwords and Shared Logins

Last one, and it connects back to everything above it. Every user needs their own login and a strong password. Not a shared "Front Desk" account. Not the same password three people know off the top of their head.

This applies even when it's tempting not to bother, like when you have a temp in for a day, or someone helping out from another location for a week. Just give them their own user. It takes a few minutes, and it solves the problem before it starts. When they're done, you hide that user so it's not cluttering up your list, but the audit trail for whatever they touched while they were there stays intact and attributable to them specifically.

Sharing logins defeats the entire purpose of having an audit trail in the first place. If three people log in as "Assistant," there's no way to know which one of them actually did something, good or bad. And weak or nonexistent passwords are just a risk sitting there with no real upside to keeping them around.

None of this is about catching anyone doing something wrong. Most of the time, nobody is. It's about being able to know, with certainty, who did what, when something does come up. That's the whole point of HIPAA compliance and fraud protection - not to mention your own peace of mind as the owner.

This is exactly why we always start with Comp Exams when working with an office. Before we talk about training your team or optimizing your workflows, we need to know what's actually sitting open in your database, because you can't fix what you don't know is a problem.

FAQs: Open Dental Security and Your Audit Trail

Q: What is the global lock date in Open Dental?
A: It's a setting under Setup > Security > Global Security Settings that blocks edits to financial entries dated on or before the lock date. Without it, payments, adjustments, and completed procedures can be changed retroactively by anyone with the right access... which means your books never really close.

Q: How often should we update the global lock date?
A: Every month, as part of your end of month process. Once the month is reconciled, lock it. If your lock date is from last year (or older), that's your first fix.

Q: What auto logoff time do you recommend?
A: Somewhere between 5 and 15 minutes of inactivity, depending on your office's workflow. Turning it off entirely is the one option we don't recommend.

Q: How many people should be in the Admin user group?
A: One, maybe two if there's a strong reason for it. Admin is for the person who manages the system, not everyone who might need something someday.

Q: Is it okay to use a shared login for temps or staff from another location?
A: No. Give them their own user, even if it's just for a day. When they're done, hide the user so it doesn't clutter your list, and the audit trail for everything they touched stays attributable to them.