Choose a dental SEO company by asking what exactly it will do each month, who will own the work if you leave, and how it will report new patients, not just rankings. Walk away from any company that guarantees a position: Google itself says "no one can guarantee a #1 ranking on Google" (Google). The best answer to most sales claims is a plain question, put in writing.
This guide gives you the questions, the red flags, what to check in a contract and a scorecard to compare proposals. We sell dental SEO ourselves, so read it with that in mind; the questions apply to us too. If you would rather do the work yourself, our dental SEO guide covers it step by step.
First: do you need a company at all?
SEO work for one practice isn't magic. Much of it is keeping a Google profile accurate, having a real page for each procedure, answering reviews and keeping listings consistent. A careful office manager can do a lot of that with a few hours a week. Hire help when nobody has those hours, when you have more than one location, or when the work needs doing properly once and then keeping up.
Look at your phones before you spend anything on search. More searchers are no use if calls go to voicemail, so run your numbers through the missed-call calculator first.
Know what you're buying
Google ranks local results on relevance, distance and prominence (Google). You can't move your office, so a company can only work on the other two. In practice, that means work you can see and check:
| Work | What you should be able to see | Ask |
|---|---|---|
| Google profiles | Correct categories, services, hours, and each public-facing dentist set up properly | What did you change this month? |
| Procedure pages | One real page for each procedure you offer, read by a dentist | Who writes them, and who checks them? |
| Insurance pages | A clear page for each plan you take | Which plans first, and why? |
| Reviews | A steady request process, with safe replies | How do replies avoid confirming someone is a patient? |
| Listings | Consistent name, address and phone everywhere | Which directories, including insurers'? |
| Local links | Dental societies, community work, local press | Can I see every link you get? |
| Reporting | Calls and new patients by source | What will the report show, and from where? |
The questions to ask
Google suggests three to begin with: "Can you show me examples of your previous work and share some success stories?", "What kind of results do you expect to see, and in what timeframe? How do you measure your success?", and how you'll communicate, including whether they will share all the changes they make to your site (Google). For a dental practice, add these:
- What exactly will you do each month, and how will I see it?
- Who writes clinical content, who reviews it, and whose name goes on it?
- Will you build a page for each nearby town? (The right answer is no, not without a real office there.)
- Will you buy links or reviews? (The right answer is no.)
- Have you read our state board's advertising rules?
- Which tracking tags will you add, and on which pages?
- Will you sign a business associate agreement if you handle patient information?
- Who owns the Google profile, domain, site and content if we stop?
- What will you report: rankings alone, or calls and new patients?
- What do you expect at 90 days and at 6 months, and how would we check?
Good answers are specific and a little boring. Be careful with any answer you couldn't explain to your front desk afterwards.
Red flags
Google warns about SEO firms that email you out of the blue, are secretive about what they do, guarantee rankings, or claim a "special relationship" with Google (Google). Dentistry adds a few of its own, because several common tactics break Google's policies, the ADA code or both:
| What you hear | Why it's a problem |
|---|---|
| "We guarantee first place" | Nobody can, and Google says to find someone else |
| "We'll build a page for every town around you" | Near-identical town pages fit Google's definition of doorway abuse |
| "We'll get you hundreds of links" | Buying links for ranking is link spam, and sites that break the policy "may rank lower in results or not appear in results at all" |
| "We publish weekly articles under Dr. Lee's name" | ADA opinion 5.F.1 treats a byline without truthful disclosure of authorship as misleading |
| "We'll call you the best implant specialist in town" | Opinions 5.F.2 and 5.H: superiority needs substantiating, and "specialist" has educational requirements |
| "Reply to reviews and mention the treatment" | HHS settled with a dental practice over patient details in review replies |
| "We own the profile and the site, it's simpler" | You lose your history if you leave |
| "The report's just your rankings" | Rankings vary by searcher and aren't patients |
One word of caution about the first impression too. A polished sales deck or a high ranking for the company's own name tells you they can sell, not that they will do careful work for a practice. Look at what they've done for others.
Check the work
Ask for three current dental clients. Then do the checking yourself; it takes less than an hour.
- Read their procedure pages. Are they specific to that practice, or do they read the same as the other clients' pages? Paste a sentence into a search in quotation marks to find out.
- Look at the Google profiles. Are the names real, or stuffed with keywords? Google's rules ask for your real-world name.
- Look for town pages. A long list of near-identical town pages in the footer is a warning.
- Read the review replies. Do any confirm that someone is a patient, or mention their care?
- Call a client who left. Ask why, and how the handover went. A company's response to that request tells you something too.
Read the contract
Most of the long-term pain comes from here, not from the SEO:
- The term, the notice period and any fee for leaving
- A written list of monthly work, not just "SEO services"
- You own the domain, website, content and Google profiles
- A handover on exit: logins, content, redirects, reports
- Any setup fee, and what it covers
- No performance claim you can't verify yourself
- Who reviews clinical content before it goes live
- A business associate agreement, if patient information is involved
If the company will handle patient information, such as sending review requests from your system, that calls for a business associate agreement. Ask which tracking tags it will add, and on which pages. HHS's bulletin on online tracking is a useful read, with its note that a court vacated part of it in 2024 (HHS). Take advice from your compliance adviser if you're unsure; this is general information, not legal advice.
State dental boards have their own advertising rules, and some are stricter than the ADA's. A company that has never asked which state you're in hasn't thought about them. Ask.
Compare proposals fairly
Monthly fees are hard to compare because proposals describe different work. Put each one through the same scorecard, using the same questions, and score each line from 0 to 2. Then work out what it needs to bring in, using your own figures:
| Monthly fee (example) | $2,000 |
| What a new patient is worth to you in margin, first year (example) | $500 |
| Extra new patients a month to cover the fee | 4 |
SEO builds over months, so don't judge it in the first few weeks. Agree in advance what you expect to see at 90 days and at 6 months, in numbers you can check: Google profile calls, website clicks and new patients by source, compared with the same month last year.
After you sign
Keep ownership clean from the first day. Add the company as a manager on your Google profile rather than handing over the login, and keep your domain, your website and your ad accounts in the practice's name. Have a dentist read every clinical page before it goes live. And hold a short review each quarter, against what you agreed at the start. If the reports stop making sense, ask; a good provider will welcome the question.
What to do this week
Write down your new patients by source for the last three months, then send the questions above to anyone you're considering, including any company already on your payroll. If you'd like to see where your practice stands first, our free practice audit looks at your Google profile and website as a new patient would, and calls your practice in and out of hours. You can use the result with us or with anyone else.
