Why These Questions Matter
Dental marketing is a crowded industry. There are thousands of agencies claiming to specialize in dental, and many of them use the same pitch: “We'll get you more patients.” The problem is that most practice owners have no framework for evaluating whether an agency can actually deliver.
The result? Practices sign 12-month contracts, pay $1,500-$5,000 a month, and six months later have nothing to show for it except a folder of PDF reports full of vanity metrics. The agency owns the website. The agency owns the ad accounts. The practice owner has no idea what is actually happening.
These 15 questions are designed to prevent that. They cover the five areas where dental marketing relationships most commonly break down: experience, ownership, strategy, reporting, and pricing. Ask them before you sign anything.
Tip: Send these questions by email before your first call. A good agency will appreciate the thoroughness. A bad agency will get defensive or dodge them. Either way, you learn something.
About Their Experience (Questions 1-3)
1. “How many dental practices do you currently work with?”
This question tells you two things: whether the agency has real dental-specific expertise, and whether you will get meaningful attention. An agency with no dental experience is learning on your dime. An agency running hundreds of accounts through a large team may be running a factory.
Good answer
“We work only with dental practices, and we limit how many accounts each person handles so yours gets real attention. Here is who would be working on it.”
Red flag
“We work with hundreds of dental practices across the country.” Or: “You'd be our first dental client, but we're fast learners.”
The number itself matters less than two things: dental-specific expertise, and how much attention your account will get from the people actually doing the work.
2. “Can you show me the reporting I would actually receive?”
A practice in rural Montana has completely different marketing challenges than one in downtown Toronto. A cosmetic dentist needs a different strategy than a family practice. Ask to see sample reporting, and ask how the agency would adapt its approach to your market size, specialty, and growth stage.
Good answer
“Here is a sample of the monthly report you would receive: ranking trajectory, lead volume, and cost per lead. If we share a real client's figures, we need their permission first.”
Red flag
“Our average client gets 50 new patients per month.” No specifics. No proof. No context about market size, ad spend, or timeline.
Be skeptical of “case studies” that only show percentage increases without baseline numbers. A 200% increase from 2 patients to 6 patients is not impressive.
3. “Do you work with any of my direct competitors?”
If the agency is running Google Ads for the practice down the street, you have a conflict of interest. You are bidding against each other while the agency collects fees from both sides. The same tension applies to SEO: it is hard for an agency to push two practices toward the same keywords in the same area without one losing out.
Good answer
“We disclose any conflicts of interest. If we already work with a practice in your immediate area, we tell you before you sign, and we explain how we would handle it.”
Red flag
“We work with several practices in your area, but we customize the strategy for each one.” That means they are competing their own clients against each other.
Agencies define “conflict” differently. A practice in north Calgary and one in south Calgary are not really competing. But two practices within a 5km radius are. Ask them how they define a conflict and how they disclose one.
About Ownership & Control (Questions 4-6)
This is the section where most practice owners get burned. The marketing looks great until you try to leave, and suddenly you discover you do not own your own website, your Google Ads history, or even your Google Business Profile access. Ask these questions before you sign anything.
4. “Who owns my website, ad accounts, and content if we part ways?”
This is the single most important question on this list. Many dental marketing agencies build your website on their hosting, under their account, using their proprietary platform. When you leave, you leave with nothing. You have to start your website over from scratch.
Good answer
“You own everything. Your website, your content, your ad account history, your analytics data. If we part ways, we transfer all assets to you within 30 days.”
Red flag
“The website is built on our platform, so it stays with us. But we can export your content.” Translation: you lose your website, your SEO history, and your rankings.
Get this in writing. The contract should explicitly state that the practice owns all digital assets including the website domain, hosting account, Google Ads account, Google Analytics property, and all content created during the engagement.
5. “What's your contract length and cancellation policy?”
Long-term contracts protect the agency, not you. If an agency needs a 12-month lock-in to keep clients, ask yourself why clients would want to leave. A confident agency offers month-to-month because they know their work speaks for itself.
Good answer
“We're month-to-month. We recommend giving SEO at least 6 months, but we don't force you to stay.”
Red flag
“It's a 12-month agreement with a 60-day cancellation notice. We need that time to show results.” If they need 12 months before you can evaluate them, that is a problem.
Month-to-month is the standard to ask for. Some agencies ask for a short initial commitment because SEO setup takes time; if so, make sure it converts to month-to-month afterwards, so the agency has to earn your business every single month.
6. “Will I have direct access to my Google Ads and Analytics accounts?”
Some agencies run your ads from their own master account. You cannot see the campaigns, the spend, or the actual performance. If you leave, your ad history, quality scores, and conversion data disappear.
Good answer
“We create the Google Ads account under your email. You have admin access. We manage it through our MCC (manager account), but you can log in and see everything anytime.”
Red flag
“We manage everything centrally. You'll see the results in our monthly report.” Translation: you cannot verify anything they tell you.
The same applies to Google Ads, Google Analytics, Google Search Console, and your Google Business Profile. You should have admin-level access to all of them from day one.
Not sure where your practice stands right now?
Before you hire anyone, get a clear picture of your competitive landscape. On a free 15-min call we'll walk through exactly what a marketing agency should be fixing.
Dentx builds custom dental websites with local SEO built in, from $2,790, and rebuilds outdated sites so they start bringing in patients again. Stuck on an old website?
About Strategy & Execution (Questions 7-10)
Many agencies sell well but execute poorly. These questions help you evaluate whether the agency has a real plan or just a sales deck.
7. “What does your onboarding process look like?”
A good agency looks before it sells. It wants to understand your current website, your Google Business Profile, your competitors, and your market before it proposes a strategy. Some agencies charge a modest diagnostic fee for that review and credit it toward the work; that is reasonable. An agency that proposes a package without looking at your specific situation is selling a template, not a strategy.
Good answer
“We start with a website and local-search review: competitive analysis, SEO review, Google Business Profile assessment, and a review snapshot. It is a modest fee, credited toward the work if you go ahead. Then we build a strategy based on what we find.”
Red flag
“We'll get you set up on our platform within a week and start running ads immediately.” No audit, no strategy, just speed.
8. “How do you approach local SEO specifically?”
Dental marketing is local marketing. Your patients are searching for “dentist near me” or “dentist [city name].” If the agency cannot articulate a specific local SEO strategy beyond “we optimize your website,” they may not understand the dental market.
Good answer
“Local SEO has three pillars: Google Business Profile optimization, local citation building and NAP consistency, and on-page optimization with local schema markup. We also focus on review generation because reviews are one of the most important local ranking factors.”
Red flag
“We do SEO. We'll optimize your meta tags and build some backlinks.” That is a 2015 answer. Local SEO in 2026 is far more nuanced.
Follow up by asking what they know about your specific market. How many practices are competing for the same keywords? What does the local search landscape look like? If they have not researched your area, that tells you something.
9. “What's your approach to Google Ads for dental practices?”
Dental PPC requires dental-specific knowledge. The keywords, the negative keyword lists, the ad copy, the landing page structure, and the conversion tracking all need to be tailored to dental. A general PPC agency running the same playbook they use for plumbers will waste your ad budget.
Good answer
“We run service-specific campaigns: one for emergency, one for implants, one for general dentistry. Each has its own negative keyword list, its own landing page, and its own conversion tracking. We track calls and form submissions separately.”
Red flag
“We'll run some ads and optimize based on performance.” No mention of campaign structure, negative keywords, or dental-specific landing pages.
Ask them what CPC range they expect in your market. Dental CPCs vary dramatically by location and service type. If they cannot give you a ballpark, they have not researched your market.
10. “How do you handle my Google Business Profile?”
Your Google Business Profile (formerly Google My Business) is one of the most important local visibility factors. It has a large influence on whether you show up in the map pack, which drives many local dental searches. An agency that treats GBP as an afterthought does not understand dental marketing.
Good answer
“We optimize your GBP categories, services, business description, and photos. We set up a review generation workflow. We post updates regularly and monitor for spam or competitor edits. You keep admin access at all times.”
Red flag
“We'll claim your listing and make sure the info is accurate.” That is the bare minimum. Any practice manager can do that in 10 minutes.
About Reporting & Communication (Questions 11-13)
A marketing agency can do great work and still lose your trust if they communicate poorly. These questions help you understand what you will actually see and hear from the agency once you are a client.
11. “What metrics do you report on and how often?”
Vanity metrics are the enemy. If your monthly report is full of “impressions” and “reach” but says nothing about phone calls, form submissions, or cost per lead, the agency is hiding behind numbers that do not matter.
Good answer
“Monthly reports cover: total leads (calls + forms), cost per lead, Google Ads spend and ROAS, organic ranking changes, Google Business Profile insights, and review growth. We also include what we did this month and what we're planning next.”
Red flag
“We send a monthly dashboard showing website traffic, social media engagement, and ad impressions.” None of those metrics tell you if you are getting new patients.
The metrics that matter for dental practices are: number of leads (phone calls and form fills), cost per lead, lead quality, and new patients booked. Everything else is a leading indicator at best.
12. “How do you track which leads came from your work?”
Attribution is where most dental marketing relationships fall apart. The agency says they generated 50 leads. Your front desk says they only booked 10 new patients. Who is right? Without proper tracking, nobody knows.
Good answer
“We use call tracking with recorded lines so you can listen to actual calls. Form submissions are tagged by source. We can tell you exactly which leads came from Google Ads, which came from organic search, and which came from your Google Business Profile.”
Red flag
“We track website form submissions and report on total traffic.” No call tracking means they are missing a large share of dental leads, which often come by phone.
Industry estimates suggest phone calls often account for somewhere around 60-80% of new patient leads, though the mix varies by practice and how the website is set up. An agency without call tracking is blind to a large share of your results.
13. “Who is my point of contact and how do I reach them?”
During the sales process, you talk to the agency's best salesperson. Once you sign, you get handed off to an account manager you have never met. Ask who you will actually be working with day-to-day, and how quickly they respond.
Good answer
“You'll work directly with me [or a named person]. We respond to emails within one business day. We also do a monthly strategy call to review performance and plan ahead.”
Red flag
“You'll be assigned to one of our account managers.” Who? Can I meet them first? What is their dental marketing experience?
Ask current clients how responsive the agency actually is. The sales process shows you their best behaviour. What matters is how they communicate six months in.
Want to talk through your practice on a quick call?
On a free 15-min call we'll walk through your competitive landscape, SEO health, Google Business Profile, and online reputation. No obligation, no sales pitch attached.
Dentx builds custom dental websites with local SEO built in, from $2,790, and rebuilds outdated sites so they start bringing in patients again. Stuck on an old website?
About Pricing & Expectations (Questions 14-15)
Money conversations are where agencies get creative with language. Make sure you understand exactly what you are paying for and what results to realistically expect.
14. “What's included in your pricing and what costs extra?”
The quoted monthly fee is rarely the total cost. Common extras include: ad spend (almost always separate), website setup fees, content creation, call tracking subscriptions, stock photography, and premium tools. Ask for a complete breakdown of what you will actually spend each month.
Good answer
“Our management fee is $X/month. Ad spend is separate and paid directly to Google; we recommend starting at $Y/month based on your market. There's a one-time setup fee of $Z. No other hidden costs.”
Red flag
“It's $3,000/month all-in.” All-in almost never means all-in. Ask specifically: does that include ad spend? Content creation? Call tracking? Website hosting?
For context, most dental marketing agencies charge $1,500-$5,000/month for management fees. Ad spend is typically an additional $1,500-$5,000/month depending on your market and goals. See our pricing page for a transparent breakdown of what each tier includes.
15. “What results should I realistically expect in 3, 6, and 12 months?”
This question is a lie detector. An honest agency will give you a nuanced answer with caveats. A dishonest agency will promise you the moon.
Good answer
“Google Ads can start producing calls within the first few weeks. SEO usually needs several months before movement is visible: many keywords may begin reaching the top 20 within 4 to 8 months, some moving into the top 10, with competitive downtown terms taking longer. These are industry-typical ranges, not guarantees; it depends on your competition, location and budget.”
Red flag
“You'll be on page one within 90 days and getting 30+ new patients per month.” Nobody can guarantee rankings. And patient volume depends on too many factors to promise specific numbers.
Important: Be wary of any agency that guarantees specific ranking positions or patient numbers. Google explicitly states that no one can guarantee a #1 ranking. Honest agencies set expectations and then work to exceed them.
Your Dental Marketing Agency Checklist
Use this as a quick reference when evaluating agencies. A strong agency should check every box.
Non-Negotiables
Strong Signals
Frequently Asked Questions
How many questions should I ask before hiring a dental marketing company?
At minimum, cover the five critical areas: experience, ownership and control, strategy, reporting, and pricing. The 15 questions in this guide cover all five. You do not need to ask them all in one call, but you should have clear answers to every ownership and pricing question before signing anything.
What is the biggest red flag when hiring a dental marketing agency?
The single biggest red flag is an agency that will not give you direct access to your own Google Ads account, Analytics, or website files. If you cannot log in and see your own data, the agency is prioritizing control over transparency. Walk away.
Should I hire a dental-specific marketing agency or a general agency?
Dental-specific agencies understand dental patient psychology, seasonal patterns, insurance vs. cash-pay dynamics, and compliance requirements. A general agency can learn, but the learning curve costs you time and money. What matters most is genuine dental-specific expertise and how much attention your account will actually get.
Is month-to-month better than a long-term dental marketing contract?
Month-to-month agreements protect you and incentivize the agency to deliver results every month. Some agencies justify 6-12 month contracts because SEO takes time, which is true, but you should still be able to leave if the agency is unresponsive or not executing. Month-to-month is the standard to ask for; if an agency wants a short initial commitment for SEO setup, make sure it converts to month-to-month afterwards.
How much should a dental marketing agency charge per month?
Most dental marketing agencies charge between $1,500 and $5,000 per month depending on services included, though tightly focused retainers start lower and full-service engagements run higher. Price on its own tells you very little. What matters is what the number buys: ask any agency, at any price, to name the specific deliverables and hours it covers. Be cautious of any retainer nobody will itemize for you, and of quotes above $7,000/month for a single-location general practice. Ad spend is almost always separate from the management fee.
How long does it take to see results from dental marketing?
Google Ads can start producing calls within the first few weeks. SEO usually needs several months before movement is visible: many keywords may begin reaching the top 20 within 4 to 8 months, some moving into the top 10, with competitive downtown terms taking longer. These are industry-typical ranges, not guarantees; results vary by competition, location, search intent and each practice's situation. A good agency will set these expectations upfront and show you leading indicators (impressions, click-through rate, ranking movement) in the first 30-60 days while you wait for the lagging indicators (new patients, revenue) to follow.
The Bottom Line
Hiring a dental marketing agency is a significant investment. Most practices spend somewhere in the $1,500-$5,000 per month range, which means a bad decision can cost you tens of thousands of dollars over a year with nothing to show for it.
These 15 questions will not guarantee you find the perfect agency. But they will help you eliminate the bad ones quickly. The agencies that answer every question clearly, directly, and without defensiveness are the ones worth your time.
And if an agency gets annoyed by these questions? That tells you everything you need to know.