Dental PPC is paid search for a dental practice: bidding on the queries a person types when they need a dentist, an implant consultation or an emergency appointment, and paying only when someone clicks. It is the fastest channel a practice can switch on and the easiest to waste money in, because clicks in this category are expensive and a booked patient is worth enough that competitors bid hard. Understanding how the auction decides who shows and what they pay is most of what a practice owner needs to judge an agency's proposal. This page covers the mechanics, the questions to ask, and the rules that govern the testimonials most dental landing pages carry.
How the auction actually decides who shows
Google Ads runs a fresh auction for every search, and position is decided by Ad Rank rather than by the highest bid. Google's help describes Ad Rank as combining your bids, the quality of your ads and website, the Ad Rank thresholds, the competitiveness of the auction, the context of the person's search, and the expected impact of assets and other ad formats. Two consequences matter for a practice. First, Google states that even if a competitor bids higher than you, you can still win a higher position at a lower price with high-quality ads and landing pages. Second, results move: the auction repeats for every search, each time with potentially different results depending on the competition at that moment, which is why a screenshot of your ad in position one proves very little. Ads that fail the eligibility thresholds, including those without a sufficiently high expected clickthrough rate, simply do not show.
Quality Score, and what it is not
Quality Score is the diagnostic Google gives advertisers, reported on a one to ten scale at keyword level and built from three components: expected clickthrough rate, meaning the likelihood the ad is clicked when shown; ad relevance, meaning how closely the ad matches the intent behind the search; and landing page experience, meaning how relevant and useful the landing page is to people who click. Each component is graded above average, average or below average against other advertisers over the last ninety days. Google is explicit that Quality Score is a diagnostic tool and not an input in the ad auction, and that it should not be treated as a key performance indicator or aggregated with the rest of your data. So an agency reporting a rising average Quality Score has reported a diagnostic trend, not a business result. The useful version of that conversation is which components are below average on which keyword groups, and what is being changed about the ad or the landing page as a result.
What a dental practice should require from an agency
Ask for call tracking that distinguishes a new-patient call from an existing patient rescheduling, because the cost per booked new patient is the only number that decides whether the channel works. Ask which conversions are counted and whether form fills, calls and chats are deduplicated. Ask how negative keywords are managed, since dental accounts leak money on job seekers, dental schools, insurance queries and do-it-yourself searches. Ask what happens to leads outside opening hours. Ask whether the account is opened in the practice's own name with the practice as owner, so the campaign history stays with you if the relationship ends; this is the single clause most often missing from a dental marketing contract. Finally, ask for a landing page that matches the ad's promise, because landing page experience is one of the three components Google grades and a page that answers a different question than the ad asked will underperform on both cost and bookings.
The rules that apply to your landing page
Most dental landing pages carry patient testimonials, before and after images or review counts, and those are advertising claims. The Federal Trade Commission's endorsement guidance requires that an endorsement reflect the endorser's honest opinion and actual experience, that a material connection be revealed clearly and conspicuously where a consumer would not expect it, and that results which are not typical be qualified with what consumers can generally expect unless you have proof the experience is typical. Incentives count, including free products, payments, gift cards or an entry into a prize draw. Selectively soliciting reviews only from patients you expect to be happy, or suppressing negative reviews, is treated as deceptive, and buying reviews from people who were never patients is clearly deceptive with enforcement reaching buyers as well as sellers. Delegating the work to an agency does not move the liability: the FTC says the advertiser is ultimately responsible for endorsements made on its behalf. Dental advertising is also regulated by state dental boards, whose rules vary, so check yours alongside the federal position.
Questions people ask about dental ppc
Why are dental PPC clicks so expensive?
Because a booked patient is worth a lot and every nearby practice knows it, so competition in the auction is intense. Google's help notes the auction reflects the competitiveness of that moment, which is why costs move with local demand and with how many practices are bidding.
Does a higher bid guarantee the top spot?
No. Position comes from Ad Rank, which combines bids with ad and website quality, thresholds, auction competitiveness and search context. Google states you can win a higher position at a lower price than a higher-bidding competitor with high-quality ads and landing pages.
Should I judge my agency on Quality Score?
Not as a headline. Google describes Quality Score as a diagnostic tool, says it is not an input in the ad auction and warns against treating it as a key performance indicator. Use its three components to direct fixes, and judge the account on cost per booked new patient.
Can we offer patients a discount for leaving a review?
An incentive creates a material connection that must be disclosed clearly and conspicuously under FTC endorsement guidance, and soliciting only patients you expect to be positive is treated as deceptive. State dental board rules may add restrictions, so check both before running any review campaign.