Start from your constraint, not their pitch. If your schedule has gaps, you need new patient acquisition; if your phones ring but do not convert, you need intake and front-desk work before more traffic. Then screen agencies on: dental-specific case evidence with real call volumes, a written month-one deliverable list, who owns your Google Business Profile and website after you leave, whether reporting resolves to booked appointments rather than clicks, and contract length. Any agency unwilling to show a named practice's before-and-after call data should be cut.
A dental agency already knows the mechanics that a generalist has to learn on your budget: insurance-driven search behaviour, procedure-level intent (implants and Invisalign convert very differently to cleanings), HIPAA-aware review handling, treatment-plan value versus first-visit value, and the local pack dynamics of a two-mile catchment. A generalist may be more creative and cheaper. The trade-off is a learning curve you pay for in months of underperformance.
For most single and multi-location practices, dental-specific wins — because the playbook is narrow and well proven, and specialists have benchmark data across dozens of practices. Choose a generalist only when you need something outside that playbook: a brand rebuild, a DSO-scale content operation, or an unusual service mix. A useful middle path is a specialist for local search and reviews, with a general partner for brand and creative.
Proximity matters less than it used to, but local knowledge still helps with competitor awareness and community link opportunities. Prioritise these instead: named dental references you can call, transparent pricing, ownership of assets in your name, call recording and tracking as standard, monthly reporting that shows new-patient calls and booked appointments, and a named strategist rather than a rotating account manager. If you do want someone local, ask which nearby practices they already serve — you do not want your agency optimising two competitors in the same zip code.
Three differences. First, procedure intent: a page targeting 'dental implants cost' must handle price anxiety, financing and clinical reassurance, which generic local pages do not. Second, insurance filtering: a large share of searchers qualify by carrier before they qualify by quality, so insurance information is conversion infrastructure, not fine print. Third, review sensitivity: dental purchase decisions are unusually review-driven, and healthcare review response has compliance constraints. The underlying local mechanics — profile, proximity, citations — are the same; the content and conversion layers are not.
A working programme runs six workstreams: Google Business Profile optimisation (correct primary category, complete services, weekly posts, populated Q&A, geo-tagged photos), procedure and location page build-out, review generation and response at pace, NAP and citation consistency across health directories, technical hygiene and page speed on mobile, and local schema. Then a conversion layer: click-to-call, online booking, and call tracking so you can see which searches produce appointments.
Profile and review work typically produces measurable call movement in six to twelve weeks, because the map pack responds faster than organic. New procedure pages generally take three to six months to rank for competitive terms like implants or Invisalign in a metro market. Full programme maturity — where you are competing for the top three map positions across your priority procedures — is usually a nine-to-eighteen-month horizon. Practices that switch agencies every six months never reach it.
Yes, and it is now a distinct workstream rather than a by-product of SEO. Patients increasingly ask assistants to shortlist practices before they search. Getting named requires consistent entity data across the web, extractable question-and-answer content covering procedures, pricing ranges and insurance, schema markup, and corroboration on the third-party sources models trust. Seal Global tracks a defined prompt set per practice so you can see whether your citation share is moving, rather than guessing.
A full-service scope covers: local SEO and Google Business Profile management, website design and conversion optimisation, procedure content, review generation and reputation management, Google Ads and paid social, call tracking and intake coaching, email and recall campaigns, and reporting. Increasingly it also includes AI search visibility. Not every practice needs all of it — a practice with a full schedule and a weak recall system should buy the recall work, not the acquisition work.
The common benchmark is 3–7% of gross collections for an established practice and 8–12% for a new or expanding one. In dollar terms, most single-location practices in competitive US metros run $2,000–$8,000 per month across all channels, with the organic and local layer typically $1,500–$3,500 of that. Judge the spend against cost per new patient and lifetime treatment value rather than as a flat cost line — a $300 acquisition cost against a $2,000 average first-year value is a strong trade.
Most do, and for a practice with immediate schedule gaps paid search is the fastest lever available. Expect $5–$25 per click on procedure terms in competitive metros, with implants and full-arch at the top of that range. The important discipline is separating budgets and reporting: paid should be measured on cost per booked appointment, organic on compounding call volume. Agencies that blend both into a single 'leads' number are usually hiding which channel is actually working.
A credible package includes mobile-first design, procedure pages rather than a single services list, online booking integration, insurance and financing information, staff and office photography, review display, HIPAA-conscious forms, speed optimisation, local schema, and ownership of the site in your name. Watch for proprietary platforms you cannot export — the site you cannot take with you is a retention device, not an asset.
Yes. Orthodontic decisions have a longer consideration window, a parent-versus-patient split in the decision unit for adolescent cases, and heavy competition from direct-to-consumer aligner brands. That shifts the mix towards consultation-offer campaigns, before-and-after visual content, financing clarity, and social channels where teenagers and their parents actually are. The local search fundamentals still apply, but the conversion event is a free consultation rather than an appointment.
Multi-location work is an architecture problem before it is a marketing problem. Each location needs its own optimised Google Business Profile, its own location page with genuinely distinct content, its own review stream and its own tracking number — while brand-level content and authority are shared. The common failure is duplicated location pages, which suppress all of them. Reporting must roll up to group level and break down to chair-level performance per site.
Treat social as trust corroboration rather than direct acquisition. What performs: real before-and-after cases with consent, short procedure explainers that defuse anxiety, staff and office personality, and patient testimonials in video. What does not: stock imagery and dental-fact carousels. Social also feeds AI search — consistent, active profiles strengthen the entity signals that determine whether assistants recommend your practice at all.
Yes. The searcher is a parent, not the patient, so the language, imagery and proof points all shift toward safety, anxiety management, appointment convenience around school hours, and insurance clarity. Referral relationships with pediatricians and schools matter more than in general dentistry, and reviews carry unusual weight because parents delegate the decision to other parents. The local search mechanics are identical; the content, photography and review-solicitation timing are not.
A functioning programme in a competitive US metro typically produces 15–40 net new patients per month for a single location once mature, at a cost per new patient of $150–$400 depending on procedure mix. Implant and cosmetic-heavy practices sit at the higher acquisition cost with far higher case value. Any agency quoting a specific patient number before auditing your catchment competition, current call volume and conversion rate is guessing.
Track six: new patient calls (and the answered rate), booked appointments from those calls, cost per new patient by channel, map pack position for your top five procedures, review volume and average rating trend, and production value of new patients. Rankings and impressions belong in an appendix. If your monthly report leads with website sessions, ask for it to be rebuilt around the phone.
Five reliable signals: reporting that never shows call volume or booked appointments; no new pages or profile posts shipped in the last quarter that you can point to; your map pack position flat or declining for your primary procedures; reviews accumulating slower than your two nearest competitors; and a strategist you cannot get on the phone. One of these is a conversation; three or more is a change.