Why Google Ads Stopped Working For Dental Practices
Results From Analyzing 400 Dental Ad Campaigns
Published by Dean Hua
I recently analyzed 400 Google Ad campaigns belonging to dental practices across the United States. My goal was to understand if dental practices were getting a return on their investment in Google Ads. We analyzed over a dozen factors that contribute to successful ad campaigns and I came to the following conclusion:
Dental practices aren't making money with Google Ads
I was floored by the results. In my six years of running pay per click marketing campaigns, I’ve seen many egregious campaign mistakes across a variety of competitive business sectors, including legal, software, and ecommerce. But I had never before seen such poorly executed Google Ad campaigns.
“Surely, pay per click advertising for dental practices can’t be that difficult?,” I thought to myself. I was surprised because there is a large ecosystem of companies catering to the marketing needs of dental offices.
Ask any dentist or office manager, and they’ll tell you they are relentlessly hounded over email, phone, and social media by agencies claiming they can attract more patients.
So with such a large marketing ecosystem available, how are dental offices unable to maximize their revenue through an important advertising platform like Google Adwords? How did the dental marketing industry miss the mark here?
By the end of this article, you’ll understand:
- How to identify inefficiencies in your Google advertising and eliminate adwaste
- Why big box digital marketing agencies are failing to deliver on their advertising promises for dental practices
- How to capitalize on the market opportunities available to your practice
How To Lose Money with Google Ads. Let Me Count The Ways
1. How Poor Account Structure Leads To High Cost Per Lead
Typically, a significant amount of the funds allocated to ad spend are needlessly wasted during the early months of the Google Ads campaign. Admittedly, even good pay per click marketers go through a discovery period that involves figuring out what works and what doesn’t work. During that period, some ad waste is inevitable.
But there’s a difference between marketing discovery and the marketing incompetence we came across while analyzing the 400 Google Ads campaigns.
Through our research, we identified two types of repeated ad spend waste common to the dental niche, including:
A - Trash Search Queries
An example of this is when you bid on “dentist in Miami”, but your ads attract search queries such as “Dentist assistant jobs in Miami.” Or when you bid on “dental implants” but you’re attracting and paying for queries such as “How much are dental implants”. This type of query is indicating someone who is in the research phase rather than the buyer phase.
B - Competitor Brand keywords
It’s common to pick up keywords relating to your local competitors. Web traffic will commonly type in a local competitor into the search engine and click on the first ad they see assuming that it’s the office they’re intending to visit but mistakenly clicked on your ad instead.
Most ad agencies are taking a reactive approach by waiting for the trash search queries to come in and then build a negative keyword list on these irrelevant queries. However, it can easily take 2-3 months before you’re able to build a sizable list and cut down on cost. And in the meantime, marketing dollars aren’t being properly spent.
Both scenarios can create a situation whereby 50% or more of your ad spend budget is wasted.
How To Fix High Cost Per Lead, Proactively
- Spend time creating proper account structure from the very beginning. Most agencies don’t devote the necessary staff or resources to do this painstaking work, making it difficult, if not impossible, to scale ad accounts for efficient ad spend.
- Ensure all local dental offices are included in a negative keyword brand list. Most advertisers don’t invest the necessary resources to review the actual query data necessary to build an accurate negative keyword list, which safeguards your ad budget from wasted clicks.
- Make sure your Google ad copy mentions your dental office. This reduces accidental clicks from visitors searching for a specific local dental office. In theory, with negative keyword lists, you shouldn’t have to do this, but by including your practice’s name, you’ve taken an additional precaution to reduce the amount of money spent on accidental clicks.
2. Conversion Marketing Is Your BFF
Most Google Ad accounts are managed by marketing agencies that perform typical bid management services such as:
- Writing ad copy
- Performing keyword research
- Optimizing ad campaigns
This is the extent to which most business owners understand Google Advertising. But these efforts, designed to direct traffic to your website, account for just 50% of the work needed to run a successful Google Ad campaign.
The other 50% of success is referred to as conversion-focused marketing. This is a set of tactics and strategies that many marketing agencies aren’t implementing in the dental marketing space. It's shown in our research that reveals that only 38% of all of the 400 websites use dedicated landing pages...something that didn't involve your homepage, about page, or contact page.
What is Conversion-Focused Marketing?
Conversion-focused marketing is the concept of improving your landing page copy and design in order to convert the traffic into patients. Remember; you don’t want more traffic, you want more leads that convert into patients.
The first step in all of this is to direct visitors to dedicated landing pages - not the homepage of your website, as is the case in our research.
And not just any landing page, but high converting landing pages.
So even though 38% of businesses were using landing pages, it doesn’t mean they were using high converting landing pages.
If you hired a Google Ads company or if you’re considering hiring one, there is a good chance that your agency isn’t doing everything needed to give you the best marketing possible. You’ll have already lost the advertising game before you’ve begun.

“Despite all the advancements in digital marketing, the dental marketing industry still lags behind in many areas including conversion focused marketing. This, despite the abundance of digital marketing companies that cater towards dentists.”
Homepages Are Public Enemy #1 to Dental Practices
Homepages are designed to include many different calls to action for all of your website visitors. Some are existing patients looking for your phone number or a form to download. Others are prospective patients who want to see what you offer. To meet the needs of these different visitors, homepages end up cluttered with many different links directing visitors to other parts of the website.
In short, the homepage lacks focus. And when you’re paying to acquire traffic, you need to be sure that every click acquired will quickly focus and lead your visitor down a specific path. In the world of conversion marketing, we have a saying; “One page, with one message, for one audience.”
Therefore, home pages are public enemy #1 to your paid advertising campaigns. This also includes the about page, contact page, or an inside page.
What Are Conversion-Focused Landing Pages and Why Are They Better?
Let’s say you are bidding on the keyword, “root canal dentist Austin Texas”. Clearly, you’re trying to attract visitors in search of a dentist who does root canals in Austin, Texas. A conversion-focused landing page will address everything a visitor needs to know about how you handle root canals.
But if you direct visitors to the homepage, with its hodgepodge of call to actions, you risk losing the visitor right away.
Let’s say you’re spending thousands of dollars advertising to attract patients in multiple treatment areas such as implants, Invisalign, and cosmetic dentistry. It’s impossible for your homepage or any single page to appropriately address all of these treatments.
Instead, the majority of your prospective patients will simply leave your homepage.

VS

The difference in how a conversion-focused landing page affects your bottom line is astronomical.
I’ve listened to many prospective and new clients complain that their homepage only converted 5% of monthly traffic into an actual lead. My experience has shown that replacing the homepage with a conversion-focused landing page can increase conversions from 5% to 15%!
Instead of only five leads a month, we produced 15 leads a month. Once you factor in the closing rate and the average lifetime value of a patient, we can see the revenue difference between a homepage and a conversion-focused landing page. The revenue difference can be as high as five or six figures on an annual basis!
So if high converting landing pages are so obvious, why aren’t more advertisers and agencies doing this? That’s a good question. This leads me to the next point below.
3. SEO Marketing Agencies Are Bad At Pay Per Click Marketing
The majority of dental practices hire SEO-focused agencies for their Google Ad campaigns, believing the agency’s claims that it can do both SEO and pay per click (PPC) marketing without ever challenging them. The former is focused on trying to organically rank your website for the search results page. The latter is focused on acquiring traffic through paid Google ads.
In my ten years of experience in digital marketing, I’ve learned that it’s rare to find an SEO-focused agency that excels at PPC. The data we’ve collected from 400 Google ad campaigns proves this point.
Every time I audit a campaign and see that it uses some sort of highly optimized search optimized page, I’m reminded of how much I hate SEO agencies.
The reality is that most agencies only have the resources to excel in a couple of areas. As a 10-year vet of the marketing industry, I know most agencies focus on selling web development and SEO because those are their most profitable digital services. There’s a reason why they lock you into long term contracts.
The Dirty Little Secret to Big Box Marketing Agencies:
Too many clients, not enough time

a common issue: marketing agency hiring employees with little experience and give them minimal directions
Full service agencies don’t allocate the proper resources to train their personnel to excel with paid advertising platforms such as Google, YouTube, and Facebook. In fact, it’s not uncommon for a single agency employee to be responsible for 30 or more client accounts per month.
It’s impossible for one person to give enough attention to your account while simultaneously managing 29 other campaigns. Think about it; that’s only 1 hour per week per account.
But it’s not just about lack of human resources. Many full service marketing agencies assign the SEO personnel to manage the pay per click marketing campaigns, be that Google or Facebook Ads. SEO and PPC are two different skill sets. Both are full time jobs by themselves and you can’t expect to have one person to excel at both. This also contributes to poor performing ad campaigns.
Good SEO Doesn’t Equal Good PPC
We observed the same pattern of mistakes occurring with most landing pages. Agencies often write robotic content that’s catered to search engine algorithms, not human beings.
Robotic SEO content focuses on tactics such as keyword density, keyword selection, and keyword quantity. In doing so, persuasiveness and readability is sacrificed.
Marketing agencies hired to do SEO and PPC are trying to kill two birds with one stone. They’re attempting to use a single page to rank well for organic search and for a paid ad campaign as well. Afterall, why put in the extra manpower and money to design a new page along with writing the ad copy? It eats into their profit. So they skip this part and you’ll never be the wiser.
Afterall, why would you be? If the office manager is liaising with the agency he/she knows very little about the process and simply trusts the word of the agency. And then the principal dentist certainly doesn’t have the time to keep up with all of this either.
How Killing 2 Birds Work In Practice
An agency may create a page to rank for “dental implants in Austin, Texas”. Interlinking, keyword frequency, and density are tactics that agencies often use to pump up SEO results.
They then attempt to reuse the same page for a Google ad campaign bidding on “dental implants in Austin Texas”.
Common thinking is that if it ranks well on Google, then it must be okay to use for Google Ads too, right?
Nope. Not okay. The principles applied to search engine optimization copywriting do not apply to pay per click advertising campaigns.
This is why dental offices lose money on Google Ads.

Most marketing agencies using the same landing page for both seo and paid ads. big no-no
“If you chase two rabbits, you will not catch either one.” Russian Proverb
To hunt down both rabbits, you need two separate hunters, both skilled at their trade. Not a jack of all trades.
SEO copywriting is focused on writing content to appease the search engines. However, copywriting for a Google (or Facebook) ad campaign is heavily reliant on a persuasive form of copywriting. There is no need to appease the search engine because we’re not trying to rank the page or appease a bot. We’re just trying to persuade an actual human being that is highly skeptical and has multiple options to choose from. Completely different art form.
This is why it’s so hard for general dentistry campaigns to make money off of Google Ads. The only reason why campaigns focused on high ticket treatments can make money is because the margins are better than general dentistry. Even then, many specialized dental practitioners are still leaving money on the table due to poor landing page optimization. I’m looking at you Mr. Orthodontist.
Solutions:
- Don’t let your agency get away with using the same page for SEO as for PPC campaigns.
- Ensure that all of your ad copy is written persuasively, with the understanding that a human being is on the other side of the screen.
- Engage in conversion rate optimization (CRO) tactics for your landing page.
There are a dozen other tactics that need to be implemented in order to run a Google Ad campaign that will make you money. Download the entire guide along with how with the data sets we used to benchmark the 400 campaigns we analyzed,
“Grow Your Dental Practice with Google Ad Secrets” [DOWNLOAD LINK]
4. You're One Touchpoint Away From A New Implant Patient
Even the best Google Ad campaigns convert just a small percentage of visitors into actual clients. Most web traffic go unconverted, for reasons including:
- Questions or concerns were not addressed on the website
- Unsure if you were the best fit for them
- Comparison shopping
- Not ready yet
Unbeknownst to most advertisers, it doesn’t take a lot more effort to convert these people. Afterall, there must have been some level of interest if they found you through an ad. They just needed an extra push in the right direction.
Meet Facebook Remarketing - The Extra Push
When we conducted our research of 400 Google Ad campaign, we found that only 20% of the 400 websites analyzed had the Facebook Pixel installed on their site.
The importance of having the Facebook Pixel installed is that it allows advertisers to track users through Facebook and show remarketing ads to those who have visited your site, through both paid or organic search. The same pixel is used for cold Facebook Advertising.
This means that only 80 of the 400 sites had a pixel installed and were possibly engaging in remarketing through Facebook. I say “possibly” because some people may have had the pixel installed but weren’t currently advertising through Facebook.
“When 80% of practices are not engaging in remarketing, they are choosing to leave money on the table by not putting a wee bit more effort into trying to convince people who have already expressed interest in your service.
80% of these practices chose to stop advertising after the first touchpoint - the initial landing page visit from a Google Ad. But what if it only took several more exposures to a few more Facebook ads to convert these people?
Most practices only need a small budget of $200 or so for their remarketing. If you land one high ticket treatment like Invisalign, cosmetics, or implants, you’ve more than made your money back.
So is it worth it?
Meet Facebook Remarketing - The Extra Push
When we conducted our research of 400 Google Ad campaign, we found that only 20% of the 400 websites analyzed had the Facebook Pixel installed on their site.
The importance of having the Facebook Pixel installed is that it allows advertisers to track users through Facebook and show remarketing ads to those who have visited your site, through both paid or organic search. The same pixel is used for cold Facebook Advertising.
This means that only 80 of the 400 sites had a pixel installed and were possibly engaging in remarketing through Facebook. I say “possibly” because some people may have had the pixel installed but weren’t currently advertising through Facebook.
“When 80% of practices are not engaging in remarketing, they are choosing to leave money on the table by not putting a wee bit more effort into trying to convince people who have already expressed interest in your service.

80% of these practices chose to stop advertising after the first touchpoint - the initial landing page visit from a Google Ad. But what if it only took several more exposures to a few more Facebook ads to convert these people?
Most practices only need a small budget of $200 or so for their remarketing. If you land one high ticket treatment like Invisalign, cosmetics, or implants, you’ve more than made your money back.
So is it worth it?
You can run ads that highlight;
- FAQs,
- Pricing or insurance concerns,
- Awards or PR mentions of your practice
- Positive patient reviews
By continually showing these ads to unconverted web traffic, you’re “touching” them until they are ready. On top of this, you’re building brand awareness within your community and establishing yourself as a trusted source for dental needs...even if it’s months down the road.
That’s killing two birds with one stone - the right way!
Why Aren’t More Practices Engaging in Remarketing?
It’s difficult to narrow it down to one reason, but I can think of several reasons including:
- Practices are inclined to believe that, like cold Facebook marketing, you need a big budget for remarketing. You don’t.
- Agencies aren’t properly staffed to handle yet another marketing service on top of their existing solutions
- Offices aren’t properly educated on the power of remarketing. It’s not that hard to implement
- 1Practices are inclined to believe that, like cold Facebook marketing, you need a big budget for remarketing. You don’t.
- 2Agencies aren’t properly staffed to handle yet another marketing service on top of their existing solutions
- 3Offices aren’t properly educated on the power of remarketing. It’s not that hard to implement
What Have We Learned So Far?
Google Ads are not working for dental offices because:
- Poor account structure is leading to ad spend waste
- Agencies aren’t going the full mile with their paid advertising services.
- Many agencies aren’t practicing conversion focused marketing.
- Practitioners aren't going beyond the first touchpoint to convert prospects into patients
What Does A Great Google Ad Campaign Look Like For a Dental Office?
Conversion Focused Marketing
Using the homepage is for lazy marketers. It results in low conversions and high cost per lead (CPL).
We do it right the first time around by leveraging high converting landing pages. CPL goes down and leads go up. Ca-Ching.


Remarketing to Unconverted Visitors
It's 2021 and consumers require more touchpoints than ever before they buy.
Facebook remarketing ads are a low cost and effective way of staying top of mind and converting visitors that didn't take action with your Google Ads.
This means less money is left on the table and a higher return on your ad spend.
Deep-Level Specialization
Jack of all trades marketing agencies are fine if you don't mind mediocre results.
But they don’t invest the time nor resources for paid traffic. It’s a deep rabbit hole and we’re in it everyday.
We live, breathe, and sleep Google and Facebook Advertising.


Advanced Conversion Marketing Tools
My background is in B2B marketing. In that industry, I had advanced marketing data and tools at my disposal that isn’t always available to a local dental practice. I bring those tools to you. Tools such as heat mapping, micro conversions, and marketing automation help power your advertising.
Most agencies don't have these sort of tools available for your dental office because they're not specialized in paid advertising. We do. And this means consistent improvements to your campaign month over month resulting in more business for you.
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