Windows 10 ESU for dental offices: what it covers and when to move to Windows 11

Windows 10 reached end of support on October 14, 2025, and many dental offices still have it on front-desk and operatory PCs. Microsoft's Extended Security Updates program keeps security fixes coming for a limited time. Here is what it covers, what it leaves out, and how to plan the move to Windows 11.

What ended on October 14, 2025

Microsoft ended support for Windows 10 Home and Pro on October 14, 2025. Version 22H2 was the final version. The PCs still start up and run your software. What stopped is the maintenance: Microsoft no longer provides technical support, feature updates or quality updates, and quality updates are where the security fixes live.

In a dental office, the front desk and operatory PCs have the practice software, the imaging software and email open all day. Each PC that stops getting security fixes is one more way into the network that holds your patient records.

What Extended Security Updates are

Extended Security Updates (ESU) is Microsoft’s paid program that keeps security updates coming to enrolled Windows 10 PCs after end of support. Microsoft says it delivers updates rated Critical and Important by the Microsoft Security Response Center.

Microsoft points individuals and Windows 10 Home users to a separate consumer program. The details below are for the commercial program that organizations use.

Who can buy Windows 10 ESU and for how long

• Microsoft says the program is open to organizations of all sizes. The minimum purchase is one license.
• Organizations buy it through Microsoft Volume Licensing.
• It is sold by the year. You cannot buy part of a year.
• It is cumulative. If you join in year two, you also pay for year one.
• PCs that belong to a business can get security updates for a maximum of three years after Windows 10 end of support.

Each PC has to be running Windows 10 version 22H2 with the updates Microsoft lists as prerequisites. The license comes as a Multiple Activation Key that you find in the Microsoft 365 admin center and activate on each PC. Running slmgr.vbs /dlv afterwards shows whether the ESU license reads as Licensed.

What ESU does not cover

ESU is security updates only. Microsoft lists what it leaves out:

• New features.
• Non-security fixes that customers ask for.
• Design change requests.
• General technical support. Microsoft supports only activation, installation and problems caused by the ESU updates themselves, and organizations need an active Microsoft support plan to get that help.

ESU also says nothing about your other software. Each vendor sets its own rules. Microsoft says it will keep providing security updates for Microsoft 365 apps on Windows 10 until October 10, 2028. Your practice management vendor, your imaging vendor and your sensor and camera makers each publish their own list of supported Windows versions. Ask each one where they stand on Windows 10 and which Windows 11 versions they support.

Windows 11 hardware requirements

Microsoft lists these minimums for Windows 11:

• Processor: 1 GHz or faster with two or more cores, on Microsoft’s list of compatible 64-bit processors.
• Memory: 4 GB or more.
• Storage: 64 GB or more of available disk space.
• Firmware: UEFI, Secure Boot capable.
• TPM: Trusted Platform Module version 2.0.
• Graphics: compatible with DirectX 12 or later, with a WDDM 2.0 driver.
• Display: 720p, a monitor of 9 inches or more, 8 bits per color channel.

To upgrade in place, a PC must already run Windows 10 version 2004 or later and have the September 14, 2021 security update or later. On Windows 10 Pro, Microsoft’s PC Health Check app tells you whether a PC qualifies. To see the version a PC runs now, open Settings, go to System, then About, and look under Windows specifications.

These are Microsoft’s minimums, not your software’s. Check the system requirements from your practice software and imaging vendors as well, since they can ask for more than Windows does.

Moving operatory and front-desk PCs

Front-desk PCs are usually the easy part. They run the practice software, a printer and maybe a card reader. Operatory PCs are harder because they drive sensors, intraoral cameras and other hardware. Each of those needs a driver that supports Windows 11 before you upgrade the PC it plugs into.

1. List every PC: where it sits, its Windows version and whether it passes the Windows 11 check.
2. Ask your software and imaging vendors which Windows 11 versions they support, and get driver versions for each sensor and camera.
3. Upgrade one front-desk PC first. Open the schedule, post a payment and print.
4. Upgrade one operatory next. Take a test image, open it in the chart and check the sensor in every room it moves to.
5. Buy ESU only for PCs you cannot upgrade or replace yet, and schedule their replacement well before ESU runs out.

ESU buys time for PCs that fail the hardware check. It does not change the hardware, so those PCs still have to be replaced.

Where we come in

We check every PC against Microsoft’s requirements, keep Windows patched and plan upgrades around your schedule as part of IT maintenance and support. If you are not sure where your PCs stand, start with a free on-site assessment.