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Dentrix performance issues on XEON Quad Core server

Dental office has all new hardware and new cabling for a 12-workstation client/server network. Workstations use Pentium D 3.0ghz processors with 1-gig DDR2 RAM, and the server is a quad core XEON 2.66ghz with 4-gigs DDR2 RAM, all Intel motherboards in reasonably high quality custom builds, new Linksys gigabit switch.

Primary patient management app is Dentrix 11, which is built around the c-tree database engine, and this particular version is well-known for slow performance over the network. All updates have been applied, including a Performance Patch update that Dentrix wrote after fielding so many complaints about Ver. 11.

Before the sweeping hardware upgrade, the network performed better on the older hardware with the same version of Dentrix. I don't know the specs of the original server, but it was probably a PIV single core, likely no faster than 1.8ghz.

Dentrix has told the dentist that Dentrix 11 is "incompatible" (the dentist's word) with the quad core processor, but has been otherwise unhelpful resolving the inconsistently slow performance and occasional freezes. The hardware guys are blaming Dentrix for the slowness. The network appears to be configured competently (although I question using the Everyone group to set permissions (see next paragraph)), and the real-time virus scan (Trend Micro) excludes the Dentrix folder on server and workstations as well and its mapped drive letter at the root for the network share.

The users all log in with the same username to the domain controlled by Windows Server 2003 Small Business Edition. The installers configured the OS so that the Everyone group has full control rights to the Dentrix folder. So in all the operatories the user is logged in as Staff and then must login again to the Dentrix app.

My main question concerns this statement from Dentrix that a quad core processor is not recommended. Without any question, Dentrix is incapable of multithreading, and so the quad core might unnecessary and not utilized. But would the presence of a quad core processer be the cause of latency in a legacy application using the old c-tree engine?

Users are experience slow updates of records, slow transition between modules, slow loading of x-ray and intraoral images, with occasional freezes of the workstations. The problem comes and goes, except for one particularly problematic workstation which has been rebuilt and OS reinstalled by the hardware vendor, without much difference.

I have advised the dentist to examine the new CAT5 cables to confirm that they avoid the ceiling lights and the x-ray equipment. I have also added file extensions DAT, IDX and VMF to the Trend Micro exclusion list (although the vendors had already excluded the entire Dentrix directory tree). I have confirmed that the workstations are connecting at 100mbps, and that there is only one DHCP server running (they turned off DHCP on the SonicWall firewall).

I also wonder about the fact that the server is running the SQL engine that loads with Small Business Server. The Dentrix software doesn't use SQL, so I don't think the SQL is doing anything but eating some RAM. But the server has planty of RAM and in watching CPU usage on hte server I never saw it spike above about 12%, and it tends to stay down around 1% or 2%.

Thank you.
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rpmaps

Why is the dental office still using Dentrix 11.0?  There have been two significant upgrades including Dentrix G2 and more recently Dentrix G3 which specifically advertises itself to be "faster loading".
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That is a good question which I have not discussed with the dentist. I know that G2 and G3 are supposed to increase performance some 30%. I have been called in behind the team that installed the new equipment because they have not been able to get Dentrix to run well on the new hardware, despite technical support conferences with Dentrix and a lot of troubleshooting of hardware. The dentist wanted a new pair of eyes on the situation, so he asked me to have a look. But I don't know enough about the engineering of processors to address the matter of Dentrix claiming that the quad core was not supported hardware.
It might not be "supported" by 11.0, but I believe it is supported by G3.  I remember a dentist telling me that Dentrix was trying to sell him a Xeon Quad Core for a server.  I checked the "minimum system requirements" for G3 and all it says is it must be at least a P4 2.4  GHz.  

http://www.dentrix.com/g3/docs/g3_system_reqs.pdf
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That is interesting that Dentrix was pushing a quad core server, considering that my dentist did not mention that Dentrix had even suggested upgrading the Dentrix package. But this dentist is one of those very busy doctors who says, "I just want it to work" and gets very frustrated when it doesn't work.

I thought that if Dentrix 11 doesn't multithread, then it would regard the Xeon Quad Core as a 2.66ghz processor and just keep on running, maybe a bit faster than before.

Is there a chance that the computers are running so fast and sending data across the network so quickly that the c-tree engine can't keep up, and the read / write commands are getting queued up waiting for the database engine to do its job?
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By the way, the hardware installers are also this area's (Raleigh NC) Dentrix specialists to some degree, and so they might already have gone a few rounds with the dentist to persuade him to upgrade. Maybe he's waiting for the SQL version to be written.
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Did Anyone specifically ask Dentrix if G2 or G3 can run on a Xeon.  We are looking at the same upgrade especially since Dentrix Image is MSSQL server based and would probably benefit from the multi-core processor.

My question is is it worth a Xeon on would a dual core or quad core Pentium do as well??
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One of the problems with getting answers in this matter is that Dentrix technical support is so inconsistent, and occasionally misleading. This was the case with my client, who was told that Xeon quad-core was "incompatible" with Dentrix 11, whereas I have found ample evidence (mostly anecdotal from folks in the field) to the contrary. Xeon quad-core is not utilized, but it is certainly not incompatible. If you comb through the huge amount of material at DentalTown (registration required), you will find that some of the most experienced Dentrix-certified sellers and supporters of dental systems do not hesitate to use and recommend Xeon processors, including quad-core, for G2 and G3. But they use Xeon because it is a common processor for a server-class computer, and not necessarily because Dentrix needs it. Plenty of practices have opted for Pentium to reduce the cost a little, and there are lots of folks of the opinion that Xeon is overkill for Dentrix. On the other hand, Schein is under so much pressure to come out with an SQL version of Dentrix (and, indeed, under condemnation for promising it for years without developing it), that when it does release one you might be in a better position if you went ahead with the Xeon processor for the time being.
Something odd I noticed with Dentrix 11 is that it performs better is you map a drive to the database on the server and not use a UNC path.
G2 will be a huge mistake. G3 might be a little better than G2. G4 is even better. Notice I did not say good - or use the words fast. If you want speed and reliability - change dental programs (Eaglesoft is a solid product). We have about a hundred installed users of Dentrix and each office is different in terms of performance. While it is true that Dentrix does not utilize the benefits of Quad Core - you can (even with SBS 2003 Standard Edition) assign a core dedicated to Dentrix. This helps - a lot. And remember -speed is often relative - and is in the mind of the user. A 4-5 second delay in pulling up a chart is acceptable to some - and totally unacceptable to others. Sullivan tech support will tell you 30 seconds is acceptable (it's not). Their support is, at best, inconsistent. Most things you just have to figure out yourself. Allow the server to do DHCP, exclude Dentrix from ANY antivirus program, assign a core to Dentrix, use gigabit NICs and switch, install 2 gb of memory (or more) in each workstation, use fast video cards with 512mb of memory, use the fastest Quad core you can find in the server, use SAS drives and 4gb of memory. Install all updates and patches for Dentrix. Beyond that - nothing else really helps.