Editor’s Note:
This is the second post in our Dental Advertising Series. If you missed the first one, start with “Advertising for Dental Practices 101: What You Need to Know Before You Spend a Dime.”
I’ve reviewed hundreds of dental marketing campaigns, and I can say this with full confidence: Google Ads are one of the most effective patient acquisition tools you have—if they’re run properly.
When they’re not? They burn your budget, waste your time, and hide the fact that your agency may not be doing their job.
This post is going to walk through:
- How Google Ads actually work
- What it should cost to get results
- Why agency math often doesn’t add up
- What a good campaign looks like
- How to spot the warning signs that your vendor is getting it wrong
Let’s get into it.
What Are Google Ads, Exactly?
Google Ads (formerly AdWords) are the paid search listings that show up at the top of Google when someone searches for a dental service. You’ve probably seen them tagged with a small “Ad” label.
You pick keywords, set a budget, and pay when someone clicks. That’s the basic idea behind PPC (pay-per-click).
But real success requires more than bidding on “dentist near me” and hoping for the best. Strategy, structure, and constant optimization matter.
Most importantly: Google Ads should be the first advertising channel you test if your goal is new patient acquisition. These are high-intent users looking for exactly what you do.
Typical Google Ads Costs for Dentists
Here’s a basic range for general dentists (specialties often pay more):
- Cost Per Click (CPC): $2.50 to $6.00
- Cost Per Lead (CPL): $40 to $100
- Cost Per New Patient: Varies, but often $150–$400 when done well
That last one—cost per new patient—is the metric that actually matters. But most agencies stop at cost per lead.
Why Budget Level Matters (Let’s Do the Math)
This is where a lot of agencies go wrong. They try to win the sale by saying, “You can get started with just $500/month!”
Let’s break that down.
Scenario: $500 Ad Budget
- Avg. CPC: $5
- That gives you 100 clicks
- Let’s say 10% convert to a lead → 10 leads
- Let’s say 20% of those leads become patients → 2 new patients
If your average patient is worth $1,200, that might sound okay. But what if your actual conversion rate is lower—or your agency is counting spam, bots, or non-qualified leads as “conversions”?
More importantly, your campaign will take months to optimize. Low budgets don’t generate enough data for Google to learn what works.
Now flip it:
- Budget: $2,000/month
- Same math = 400 clicks → 40 leads → 8 new patients
- You’ve collected 4x the data, optimized faster, and potentially added $9,000+ in collections.
The bottom line: Your budget should be set based on the value of a new patient and how fast you want to grow—not what “feels” safe.
If your agency isn’t walking you through this math, they’re not guiding you properly.
What a Well-Run Google Ads Campaign Looks Like
I know a good campaign when I see one. Here’s what you should expect:
- Clear goals: Emergency patients, implants, Invisalign, hygiene reactivations—pick one.
- Targeted keyword strategy: Includes negative keywords and correct match types (not just broad match nonsense).
- Smart bidding: Manual CPC or well-tested automated strategies—not “set and forget” with conversion-based bidding from Day 1.
- Optimized landing pages: Mobile-friendly, fast, and conversion-oriented.
- Real analytics: Tracking appointments and outcomes, not just calls and clicks.
- Account ownership: You have admin access and full control of the data.
If you’re not seeing these? Time to start asking questions.
Symptoms That Your Google Ads Campaign Is Off Track
These are the signs I see most often in underperforming accounts:
Symptom: You’re getting calls or form fills, but no new patients.
What it might mean:
- Bad targeting (wrong keywords or match types)
- Poor landing page experience (slow, unclear, not mobile-friendly)
Symptom: Your agency keeps saying “Google needs 90 days to optimize.”
What it might mean:
- They’ve set the campaign to “maximize conversions” too early, and Google is optimizing for the wrong actions (like brand searches or internal traffic).
Symptom: You see tons of “conversions” on your reports—but they’re spam or bots.
What it might mean:
- No click fraud protection, bot filters, or spam-blocking on form tools. This is common with Leadpages and other cookie-cutter platforms.
Symptom: Budget is disappearing, but you’re not sure where it’s going.
What it might mean:
- Agency is using broad match terms like “Invisalign” that capture search queries like “Invisalign problems,” “Invisalign reviews,” or “Invisalign for teens.”
Symptom: You’ve never seen your own Google Ads account.
What it might mean:
- You don’t own it. If the agency disappears, so does your data, history, and control.
Symptom: They’re using your homepage as the landing page.
What it might mean:
- They’re skipping conversion rate optimization (CRO). A good homepage can work—but most agency-built sites aren’t structured to convert ad traffic.
Wait—What About LSA and Performance Max?
Good question. Let’s touch on both.
Google Local Services Ads (LSAs)
These are the boxy “Google Guaranteed” ads that show up above regular PPC ads.
- You pay per lead (calls or forms)
- High visibility with Google reviews and business info
- Quality can vary, depending on your profile setup and service area
Tip: Make sure your agency isn’t just letting Google auto-fill your categories or set too-wide a service radius. That’s a common reason for bad LSA leads.
Performance Max Campaigns
These are Google’s latest all-in-one campaign types, and they can work—but only when set up carefully.
A lot of agencies throw all your assets into one big campaign and hope for the best. That’s a mistake.
- You need segmented asset groups
- Careful exclusions to avoid bad placements
- Clear goals and daily oversight
Otherwise, you’re just paying for placements in YouTube, Gmail, or random display networks with little ROI.
CPC and CPL Myths (And Why Agencies Get It Wrong)
A final note here: don’t let an agency sell you on “low CPC” as a win.
If a $100 click turns into a $3,000 implant case, that’s a win.
CPC is a budgeting metric—not a performance one.
Same goes for “conversions” if your agency is calling form fills or spammy calls conversions. That’s not a lead. And it’s definitely not a new patient.
Only the practice can define what a qualified lead is. You know what your team can follow up with. You know who books and who shows. That’s how you calculate actual ROI.
Any agency that doesn’t work with you on your definition of success isn’t setting you up to win.
Final Thoughts
I’m bullish on Google Ads. When done right, they work—and fast.
But the average dental marketing agency isn’t running these campaigns with enough expertise, transparency, or respect for your business goals. That’s why you have to own your data, understand the math, and hold vendors accountable.
If you’re spending money on ads, you deserve more than mystery reports and “give it 90 days.”
In our next post, we’ll cover Facebook and Instagram ads for dental practices—what they’re good at, where they fall short, and how they can complement a smart Google strategy.
Stay tuned.