The purpose of this article is to detail the primary challenges faced by large dental institutions as they incorporate digital dentistry into their mainstream workflow. Integration of digital technology is easier in private practices with smaller patient volumes and fewer trained staff required. Additionally, in private practices, scanning, designing and milling frequently occur in a single location, which does not require an external digital data transfer. However, large dental institutions must overcome several barriers which are uniquely generated by their large-scale operation. Numerous individuals must be comprehensively and efficiently trained to operate the advanced technologies. The digital software must seamlessly integrate with existing software and an internal infrastructure must be established capable of handling massive data inputs. High-volume production in large dental institutions requires the involvement of external laboratories to meet demand. This outsourcing presents a new challenge of safe digital data transfer in accordance with patient privacy and protection regulations set forth by governing agencies. It is vital for large dental institutions to recognise the unique challenges thrust upon them as they attempt to incorporate a digital workflow. With proper forethought and planning an appropriate infrastructure may be established allowing for a smooth and safe transition to the digital era.