Microsoft 365 Licensing for Dental Practices: What You Actually Need

Why Licensing Matters

Microsoft 365 (M365) is essential for most dental practices—but choosing the wrong licenses wastes thousands of dollars annually. Many practices assign Business Premium ($22/user/month) to every employee when many users only need Basic or Standard licenses ($6-$12/user/month).

Example: A 15-person practice paying for 15 Business Premium licenses spends $3,960/year. With optimized licensing (mixing Premium, Standard, and F1), the same practice could spend $2,160/year—saving $1,800 annually.

Understanding the M365 License Tiers

Microsoft 365 Business Basic ($6/user/month)

What's included:

• Email (50 GB mailbox)
• Web-based Office apps (Word, Excel, PowerPoint online only—no desktop installs)
• OneDrive cloud storage (1 TB)
• Teams (chat, video meetings)
• SharePoint

Best for:

• Front desk staff who primarily use email and web apps
• Part-time employees
• Roles with minimal document creation needs

Microsoft 365 Business Standard ($12.50/user/month)

What's included:

• Everything in Basic
• Desktop Office apps (Word, Excel, PowerPoint, Outlook, Publisher, Access)
• Larger mailbox (50 GB)

Best for:

• Administrative staff who create documents/spreadsheets
• Office managers
• Billing and insurance coordinators

Microsoft 365 Business Premium ($22/user/month)

What's included:

• Everything in Standard
• Advanced security features: Threat protection, DLP, information protection
• Device management (Intune—manage mobile devices and laptops)
• Advanced compliance tools
• Azure AD Premium P1 (conditional access, MFA enforcement)

Best for:

• Providers (doctors, hygienists with admin access)
• Practice owners and administrators
• IT administrators
• Anyone handling sensitive financial or clinical data

Microsoft 365 F1 ($4/user/month)

What's included:

• Email (2 GB mailbox)
• Teams (chat only, no meetings)
• Web apps only (no desktop installs)
• OneDrive (2 GB)

Best for:

• Dental assistants who only need email and internal chat
• Highly specialized roles with minimal computer use
• Not recommended for most dental practices (too limited)

Recommended Licensing Strategy by Role

Providers (Dentists, Specialists)

Recommended: Business Premium ($22/month)

Why: Need advanced security, device management, and full Office suite for treatment planning and reports.

Office Manager / Practice Administrator

Recommended: Business Premium ($22/month)

Why: Handle sensitive financial data, manage staff accounts, require advanced security.

Front Desk / Scheduling

Recommended: Business Standard ($12.50/month)

Why: Need full Outlook desktop app for heavy email use, document creation for forms/letters.

Dental Hygienists

Recommended: Business Standard ($12.50/month)

Why: Use email, create patient education materials, access charting if PM software integrates with Office.

Dental Assistants

Recommended: Business Basic ($6/month) or Business Standard ($12.50/month)

Why: Minimal document creation; email and Teams sufficient. Upgrade to Standard if they create documents frequently.

Billing / Insurance Coordinator

Recommended: Business Standard ($12.50/month)

Why: Heavy Excel use for financial tracking, email for insurance communication.

Security Add-Ons to Consider

Microsoft Defender for Business ($3/user/month)

• Endpoint protection (antivirus, anti-malware)
• Threat detection and response
• Centralized management console

Recommended for: All users if not using Business Premium (which includes some security features).

Microsoft Defender for Office 365 Plan 1 ($2/user/month)

• Anti-phishing protection
• Safe attachments (sandboxing)
• Safe links (URL rewriting)

Recommended for: Users frequently receiving emails from external sources (front desk, billing).

Azure AD Premium P2 ($9/user/month)

• Advanced identity protection
• Privileged Identity Management (PIM)
• Access reviews

Recommended for: Admin accounts only (practice owner, IT admin)—not all users.

Sample Licensing Plans for Dental Practices

Small Practice (1 Doctor, 5 Staff)

• 1× Business Premium (dentist): $22/month
• 1× Business Premium (office manager): $22/month
• 2× Business Standard (front desk, hygienist): $25/month
• 2× Business Basic (assistants): $12/month
• Total: $81/month ($972/year)

Mid-Size Practice (3 Doctors, 12 Staff)

• 3× Business Premium (dentists): $66/month
• 2× Business Premium (office manager, admin): $44/month
• 4× Business Standard (front desk, hygienists, billing): $50/month
• 6× Business Basic (assistants): $36/month
• Total: $196/month ($2,352/year)

Large Multi-Location Practice (6 Doctors, 25 Staff)

• 6× Business Premium (dentists): $132/month
• 4× Business Premium (admins, managers): $88/month
• 8× Business Standard (front desk, hygienists, billing): $100/month
• 12× Business Basic (assistants): $72/month
• Total: $392/month ($4,704/year)

HIPAA Compliance Considerations

Microsoft 365 can be HIPAA-compliant, but you must:

1. Sign a Business Associate Agreement (BAA)

Microsoft offers a BAA for Business Premium, Business Standard, and E3/E5 enterprise plans. Request it through your Microsoft representative or admin portal.

2. Enable Security Features

• Multi-Factor Authentication (MFA) for all users
• Data Loss Prevention (DLP) policies to prevent PHI leaks
• Email encryption for external communications
• Audit logging enabled

3. Train Staff on Secure Use

• Don't send PHI via unencrypted email
• Lock workstations when stepping away
• Use strong, unique passwords with MFA

Common Licensing Mistakes to Avoid

1. Assigning Business Premium to Everyone

Most staff don't need advanced security features included in Premium. Reserve it for admins and providers.

2. Using Free Personal Accounts for Work

Personal Outlook.com or Gmail accounts aren't HIPAA-compliant and lack business controls. Always use licensed business accounts.

3. Not Leveraging Existing Licenses

If you're already paying for Office 365 E3 or E5, you may have unused features. Audit your current licenses before buying add-ons.

4. Forgetting to Remove Licenses for Former Employees

Deactivate licenses immediately when staff leave to avoid paying for unused accounts.

How to Purchase and Manage Licenses

Purchase Options

• Direct from Microsoft: admin.microsoft.com (best for small practices)
• Through a Cloud Solution Provider (CSP): Often provides better support and bundled IT services
• Through an MSP (Managed Service Provider): Includes licensing + IT management

License Management Best Practices

• Assign licenses based on role, not seniority
• Review quarterly for unused or underutilized licenses
• Document which staff have which license tier and why
• Train admins on how to assign/remove licenses

Conclusion

The right M365 licensing strategy balances cost, functionality, and security. Don't overpay by giving everyone Business Premium, but don't underspend on security for critical roles. Use the M365 Licensing Estimator to calculate costs based on your staff mix, then purchase through a CSP or MSP for ongoing support.

Remember: M365 is only HIPAA-compliant if configured properly. Ensure you have a signed BAA, enable MFA, and train staff on secure usage.