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A practical audit guide for dental practice owners — based on real campaign
reviews of clinics that have already tried (and lost money on) PPC.
9+ years auditing Google Ads accounts
for dentists across the US, UK and
Canada. Google Ads & Analytics
certified. Lead author of Remedo’s dental
PPC playbook.
9+ years auditing Google Ads accounts
for dentists across the US, UK and
Canada. Google Ads & Analytics
certified. Lead author of Remedo’s dental
PPC playbook.
Editorial policy: We don’t accept paid placements in our blog content. Some links go to our own services — clearly marked. Read oureditorial standards and affiliate disclosure.
Most dentists refer us to patients who have already tried out numerous PPC campaigns and have yet to see consistent growth from doing so. The very first thing we do in our initial audit is check out their campaign structure and the way it's being used. In most cases, the problem lies not in the platform itself, but in the structure of the campaign and its management.
The most frequent problem we face is the money spent on unqualified keywords, overly broad campaigns, and clicks that never result in an enquiry or booking. In some instances, a huge share of their monthly budget is wasted on driving traffic that cannot possibly convert into an appointment. It makes one feel like PPC isn't effective, which, on the contrary, is far from the case – all that's required is changing the strategy of the campaign.
A highly competitive environment requires careful management of the budget, and a wrong strategy can result in a loss of valuable resources.
In this article, we will discuss ten clear signs that prove your PPC agency for dentists spends your marketing budget on nothing useful, and how you can solve the problem to achieve better results.
This is one of the most serious red flags, and it happens more often than most dental practices realize. Many practices are paying agencies that run ads through the agency’s own Google Ads account instead of setting up an account owned by the practice.
When this happens, you do not truly own your campaigns. If the relationship ends or issues arise, the agency can take everything with them, including campaign data, ad copy, keyword history, and performance insights built using your budget. You are left starting from scratch.
Agencies that follow transparent processes, similar to those explained in this guide on how to choose a reliable dental Google Ads agency, always ensure account ownership stays with the practice.
This is one of the most common issues in dental PPC reporting. Many agencies focus on metrics like clicks, impressions, and click-through rates without connecting them to actual patient outcomes. While these numbers show campaign activity, they do not reflect real results for your practice.
For a dental practice, the only metrics that truly matter are how many patient enquiries are generated, how many of those convert into booked appointments, how many patients show up, and the revenue those campaigns produce. Everything else is secondary.
A well-built approach, like those outlined in this detailed Google Ads strategy guide for dental clinics, focuses on real patient acquisition instead of vanity metrics.
In Google Ads, negative keywords are search terms you explicitly exclude from triggering your ads. They are not a nice-to-have — they are a fundamental hygiene element that prevents your dental budget from being wasted on searches that have nothing to do with booking a dental appointment. A dental Google Ads account without a robust negative keyword list is like a fishing net with no mesh — it captures everything, including most of what you definitely do not want to pay for.
For a dental practice, the negative keyword list should include: NHS-related terms, job and career searches, DIY dental searches, requests for dental school or education, competitor brand names (unless running specific competitor campaigns), searches for dental supplies or equipment, pediatric-only terms if you do not serve children, and dozens of geographic exclusions for areas outside your service zone. A professionally managed dental Google Ads account should have 100–200+ negative keywords, reviewed and expanded monthly as new irrelevant search terms appear in the search term report.
To understand how to refine targeting, review this practical guide on using negative keywords to reduce wasted ad spend.
This is one of the most common and most expensive errors in dental PPC management. When a patient clicks a Google Ad for "dental implants near me" and lands on a dental practice's general homepage, with its navigation menu, every service listed, and no single clear call to action, conversion rates collapse. The homepage has 8 to 12 potential exits, including navigation links, service pages, about pages, and blog posts. A dedicated landing page should have exactly one focus: contacting the practice.
Google Ads Quality Score, which directly determines your cost per click and ad positioning, is significantly influenced by landing page relevance. An ad for "Invisalign consultation" pointing to a homepage scores lower than the same ad pointing to a dedicated Invisalign landing page. As a result, you pay more per click and appear lower in search results due to poor landing page alignment.
A patient searching for a specific treatment expects a focused experience. When that expectation is not met, they leave without taking action.
This level of structured execution is typically part of professionally managed campaigns offered through specialized PPC services for healthcare providers.
We’ll review your last 90 days of search terms and show
you exactly where your budget is leaking — free, no
commitment.
Cost per acquired patient is the most important metric in dental PPC. It directly connects your ad spend to real business outcomes, a new patient booking and showing up. With an average patient value ranging from $600 to $1,200 annually, knowing your CPA makes it clear whether your campaigns are profitable or not.
If your agency cannot clearly tell you your cost per acquired patient, or avoids the question with vague explanations, it usually means proper tracking is not in place or the numbers are not being monitored closely. Both situations indicate a lack of accountability.
Well-managed dental PPC campaigns tend to fall within predictable CPA ranges. If your numbers are significantly higher, it usually points to issues in targeting, campaign structure, or landing page performance.
Dental patients call. They do not always fill out a form first. In most dental practices, 60–75% of new patient inquiries from Google Ads arrive as phone calls rather than form submissions. An agency that is not tracking phone calls as conversions in Google Ads is optimizing the campaign on incomplete data — and potentially making bidding, keyword, and budget decisions based on a measurement system that is missing the majority of actual conversions.
Call tracking in Google Ads requires either enabling Google's built-in call conversion tracking (which tracks calls to a forwarding number displayed in your ads and on your website when visited from a Google click) or using a third-party call tracking platform like CallRail, WhatConverts, or Weave. Without this in place, your agency cannot tell you how many calls the campaign generated, which keywords and ads produced the most calls, or what your true cost-per-patient-call is.
What Proper Call Tracking Enables:
A dental Google Ads campaign that runs on the same budget for 12 or more consecutive months without any adjustment, either up or down, is rarely actively managed. Google Ads performance is dynamic. Cost per click changes seasonally. Competition increases and decreases. New procedures become priority targets. High-performing campaigns should receive more budget, while underperforming areas need to be reduced or refined. A fixed budget month after month is a strong signal that active analysis and optimization are not taking place.
Active management of a dental Google Ads account should include: monthly budget review against performance data, reallocation between campaigns based on cost-per-acquisition results, keyword bid adjustments based on conversion data, dayparting adjustments (shifting budget toward the hours that produce the most calls), and geographic bid modifiers to invest more heavily in the ZIP codes producing the best-converting patients.
What Monthly Optimization Should Look Like:
In 20 minutes, we’ll walk you through what your current agency is (and isn’t) doing — and what it’s costing you.
A properly structured dental Google Ads account does not run all treatments in a single campaign. It runs separate campaigns for each high-value service category: dental implants, Invisalign/clear aligners, teeth whitening, emergency dental, and general new patient acquisition. This matters for three specific reasons: budget control, bidding strategy, and message matching.
When multiple treatments run in one campaign, budget allocation becomes unclear. High-value treatments may receive less spend, while lower-value services consume more of the budget. This limits overall return and reduces efficiency. Patients searching for different treatments are at different stages of decision-making. They require specific messaging and should be directed to relevant landing pages. A single campaign with the same ads and landing page fails to meet these expectations and reduces conversion potential.
Google Ads performance is never static. The ad copy that performed best six months ago may no longer be the top performer today. The landing page headline that feels right may be underperforming compared to an alternative. The only way to identify improvements and increase performance over time is through consistent A/B testing of both ad copy and landing page elements. A dental Google Ads agency that has never shown you any tests, never reported which ad variant performed better, and never shared landing page conversion data is not running a true optimization program. It indicates a set approach where campaigns are left unchanged, leading to stable but limited results. Continuous testing is what drives consistent improvement and stronger outcomes.
The previous red flags are operational. This one is relational, and often the most revealing. An agency that responds to clear, data-driven questions with defensiveness, vague answers, or comments suggesting you would not understand the technical side is sending a strong signal. It usually means they do not want you to see what is actually happening inside your campaigns.
A competent PPC agency values transparency. They explain performance clearly, answer questions directly, and help you understand how your campaigns are working. When you understand the results, you are more confident in the investment and more likely to continue and scale.
Resistance to simple questions often indicates deeper issues such as poor performance, unclear reporting, high hidden fees, or lack of active management.
Understanding the red flags is only useful if it helps you identify and build a better relationship. Here is what the standard of care looks like from a genuinely accountable PPC agency:
1. You Cannot Access Your Own Google Ads Account
2. Reports Show Clicks, Not Patients
3. No Negative Keyword List
4. Traffic Goes to Your Homepage
5. They Don’t Know Your Cost Per Patient
6. No Call Tracking Configured
7. Budget Never Changes
8. Everything Runs in One Campaign
9. No A/B Testing Has Been Run
10. They Become Defensive on Direct Questions
What a High‑Performing PPC Agency Looks Like
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