United Kingdom · head to head · updated 2026-08-01

EXACT vs R4

The two entrenched UK systems, head to head. Both are cloud or on-premise, so the hosting decision is not what separates them.

EXACT

Software of Excellence (Henry Schein One)

The long-standing UK incumbent — the system most British practices already run.

Deployment
Cloud or on-premise
Entry price
Not published
Built for
Solo, 2–4 locations, Group, DSO / enterprise
Visit EXACT(opens in a new tab)

Read the full EXACT review

R4

PracticeWorks Ltd (Carestream Dental)

Carestream’s long-running UK practice management system, tightly paired with its imaging.

Deployment
Cloud or on-premise
Entry price
Not published
Built for
Solo, 2–4 locations, Group
Visit R4(opens in a new tab)

Read the full R4 review

The short answer

Neither EXACT nor R4 publishes a price, so any cost comparison between them depends entirely on the quotes you negotiate.

Choose EXACT if…

Established NHS and mixed practices that value ecosystem breadth and easy hiring over price transparency.

Choose R4 if…

Practices already committed to Carestream imaging.

Where they actually differ

On our module checklist these two match on every line — the decision comes down to price, support and how each one feels to use.

Show all 19 modules, including where they match
ModuleEXACTR4
Scheduling Built in Built in
Clinical charting Built in Built in
Perio charting Built in Built in
Native imaging Built in Built in
Billing Built in Built in
Claims Built in Built in
Insurance eligibility Built in Built in
Payments Via integration Via integration
Patient messaging Paid add-on Paid add-on
Online booking Paid add-on Paid add-on
Digital forms Paid add-on Paid add-on
Recall / reactivation Built in Built in
Analytics & KPIs Built in Built in
ePrescribing Not stated Not stated
Teledentistry Not stated Not stated
AI features Not stated Not stated
Open API Via integration Via integration
Multi-location Built in Built in
Orthodontics Built in Built in

Pricing, side by side

EXACT

No published pricingchecked2026-08-01

EXACT does not publish a price. You have to request a quote, which means you cannot budget or compare before speaking to a salesperson. No figure published anywhere on the site.

We do not repeat third-party price estimates for quote-only vendors. Several widely republished figures in this category turned out to belong to a different product — see how we compare.

R4

No published pricingchecked2026-08-01

R4 does not publish a price. You have to request a quote, which means you cannot budget or compare before speaking to a salesperson. No figure published.

We do not repeat third-party price estimates for quote-only vendors. Several widely republished figures in this category turned out to belong to a different product — see how we compare.

Strengths and trade-offs

EXACT

Strengths

  • The largest installed base in UK dentistry — staff arrive already knowing it, and almost every UK dental product integrates with it.
  • NHS claiming and UDA reporting are long-established and well understood, which matters more than any feature list for an NHS practice.
  • Backed by Henry Schein One, with a large partner ecosystem.

Trade-offs

  • No published pricing.
  • A mature product carrying a lot of history; the interface shows its age next to the cloud-native entrants.
  • Sold with support and hardware bundles, so the quoted figure is rarely just software.

R4

Strengths

  • Tight integration with Carestream imaging hardware, which a great many UK practices already own.
  • Mature NHS claiming, and a large enough installed base that peer knowledge is easy to find.
  • Available cloud or on-premise.

Trade-offs

  • No published pricing.
  • Closely tied to the Carestream ecosystem, which narrows hardware choice.
  • Slower feature cadence than the cloud-native UK entrants.

Other comparisons