Years ago, when I led a lead generation business in the automotive industry, we lived and died by the math. Car dealers paid us per lead—real leads—and we optimized every dollar spent to stay profitable. Cost per lead was king. If a franchise dealer paid us $40 for a qualified finance lead, we had to generate it for $20 or less to make our model work.
We were ruthlessly efficient because we had to be. If the leads didn’t convert, we lost our client.
Fast forward to today, and I’m helping doctor-owners manage marketing efforts that are, frankly, decades behind that model. And it shows.
The big difference? In dentistry, the stakes aren’t just financial—they’re operational, emotional, and reputational. When you get bad leads in a dental practice, it doesn’t just waste money. It wastes time, burns out your team, and kills trust.
So let’s be clear: yes, there is such a thing as a bad lead. And it’s time more dental and orthodontic marketing companies admitted that.
Editor’s Note:
This is the fourth post in our Dental Advertising Series. If you missed the earlier ones, you can start with:
- Advertising for Dental Practices 101: What You Need to Know Before You Spend a Dime
- Google Ads for Dentists: How to Make It Work (And Spot the Nonsense)
- Facebook Ads for Dentists: What They’re Good For (and What They’re Not)
The Shift from New Patient Consults to “Leads”
It wasn’t that long ago that most doctors I spoke with weren’t even using the word “leads.”
They wanted new patient exams or ortho consultations. Period.
Then the agencies came in and started selling “lead generation packages,” and suddenly, practices were flooded with names, emails, and phone numbers.
But what kind of leads?
- People outside your market?
- Tire-kickers who just wanted to download an offer?
- Bots?
- Duplicate form fills?
- No-shows with no intent to ever return?
The answer: often, all of the above.
Case Study: 155 Leads, 2 Case Starts
I recently reviewed performance data from a single-location orthodontic practice in a mid-sized U.S. market. The marketing agency had delivered 155 leads over a two-month period.
Using disciplined follow-up and automation software, the team was able to reach just 22 of them.
Of those 22, only 2 cases started.
His ad spend: $14,000 ($7,000/month) and Agency fees: $3,500/month
Total spend: $21,000. Result: 2 cases.
The agency pointed to internal follow-up as the issue, placing the blame on the practice rather than re-evaluating their campaign approach.
But when you look at the numbers—the low connect rate, the minimal conversions, the cost per acquisition, lead loss reasons—the real problem wasn’t the team.
It was the lead quality and the campaign strategy.
The Problem with “There’s No Such Thing as a Bad Lead”
Some agencies promote the idea that “there’s no such thing as a bad lead.”
The implication? Every lead can be nurtured. Every lead might close someday. Maybe in a week. Maybe in a year.
That might work if you’re selling SaaS or used cars.
But dentistry—and especially orthodontics and other specialties—isn’t like that.
Orthodontists have windows of opportunity. There’s timing involved. There’s age appropriateness. There’s insurance and financing.
The idea that every lead can be closed with enough follow-up is not only wrong—it’s disrespectful of your time, your team, and your business model.
What Does a Bad Lead Look Like?
Doctors don’t need marketing jargon. You know a bad lead when you see one. But for clarity, here are some symptoms:
Symptom: Your staff is demoralized.
What it might mean: They’re making call after call to people who never respond, hang up, or say “I never filled anything out.”
Symptom: Your consult calendar is full, but your treatment starts are flat.
What it might mean: Your campaigns are generating names, not interest. People are booking but not showing or not converting.
Symptom: Your ads seem to work, but you’re spending a fortune per start.
What it might mean: Your campaign is optimized for “conversions,” not case starts. The agency is managing CPC metrics that don’t translate to real business outcomes.
Symptom: Your “leads” don’t even live nearby.
What it might mean: Your agency is targeting your entire DMA (designated market area) rather than your true patient draw radius.
Symptom: You’re constantly told to “just follow up better.”
What it might mean: The problem isn’t your team. It’s that your marketing partner doesn’t want to admit their system isn’t working.
The Opportunity Cost Is Real
Let’s say your practice does 20 consultations a month. And 6 of those are no-shows or unqualified.
That’s 6 hours of chair time, staff time, overhead, scheduling effort—gone.
Now multiply that by 12 months. That’s more than a full workweek lost per year to time-wasters.
In the business world, we call that opportunity cost. In a dental practice, we call it burnout.
How to Fix It (or at Least Improve It)
This isn’t just about avoiding your dental marketing agency. It’s about taking back control of your growth strategy.
Here’s what to look for and ask:
- Do you own your ad accounts? If not, start there.
- Are you targeting your actual patient draw area? Not your entire DMA.
- Is your campaign optimized for booked consults, not just leads?
- Can you define a lead? Hint: it’s not just a form fill.
- Do you have spam filters and bot blockers? You should.
- Is your landing page qualifying people? Or just collecting names?
- Are you reviewing CPL and cost per start? You need both.
Final Thoughts
I don’t want to declare war on agencies. I work with plenty of good ones. But I do want to speak up on behalf of the doctors I serve.
Bad leads aren’t just annoying. They’re expensive. They’re demoralizing. They create friction where there should be momentum.
If your agency isn’t helping you measure, qualify, and optimize lead quality, then they’re not serving your best interests.
And if you’re not sure what good looks like? I can help.
In our next post, we’ll talk about benchmarks: what you should expect to pay for a qualified dental lead, and how to calculate if your ad campaigns are really working.
Stay tuned.