Smile Design provides comprehensive dental services, from cosmetic dentistry to routine checkups, across more than fifty locations. Its marketing spend had grown without a matching return, and too many leads were low quality. We rebuilt its paid search and paid social around lead quality and proper measurement, delivering a 20% increase in PPC conversion rate and a 30% decrease in cost per call while keeping the budget stable.
At a glance
- Client: Smile Design, multi-location dental group (50+ locations)
- Services: PPC management, paid social, analytics and tracking
- Key results: +20% PPC conversion rate, −30% cost per call, better lead quality from social media
The challenge: more spend, more leads, not more patients
Smile Design came to us with four connected problems:
- Inflated marketing spend with stagnant ROI. Budgets had grown, but returns had not.
- A high volume of low-quality leads. Front desks were spending time on enquiries that never became patients.
- Capacity issues for new patients. Some locations were busier than others, so the same lead had different value depending on where it landed.
- Underdeveloped tracking and analytics. Without reliable data, nobody could see which campaigns and locations were actually producing patients.
For a multi-location dental group, these issues compound. Each clinic has its own catchment, services and capacity. When advertising is run as one undifferentiated pot, money drifts to whatever generates cheap form fills, not to the treatments and locations that matter. Cosmetic and implant patients are worth far more than a routine enquiry, yet a campaign optimized only for lead volume treats them the same.
The goals
Smile Design wanted a marketing partner that could manage budget efficiently across 50+ locations with a well-organized strategy. The goals were to:
- Reduce customer acquisition cost (CAC) for paid search.
- Increase patient volume while keeping spend stable.
- Improve lead generation, cost per lead and new patient bookings across locations.
Our approach: a simpler structure, backed by proper analytics
The core decision was to simplify. A sprawling account across dozens of locations is hard for people to manage and hard for ad algorithms to learn from. We built a cleaner PPC and paid social strategy and put the tracking in place to judge it on quality, not just quantity.
Fixing measurement first
Before optimizing anything, we needed to trust the data. That meant tracking calls and form leads by location, measuring call duration as a signal of genuine enquiries, and separating new patient enquiries from existing patients and spam. Without this, any “improvement” in cost per lead could simply mean cheaper junk leads.
Part one: an efficient multi-location PPC strategy
Segmenting keywords by funnel stage
Someone searching “dental implants cost” is at a different stage from someone searching “emergency dentist near me” or “best cosmetic dentist”. We grouped keywords by funnel stage so each searcher saw information suited to where they were in their decision, and so budgets could be set for each stage rather than letting research searches consume money meant for ready-to-book patients.
Consistent pre-click and post-click experiences
The ad and the page it leads to should feel like one conversation. If an ad mentions a specific treatment at a specific location, the landing page should show that treatment, that clinic, its address and a way to book. Consistency improves conversion rate and Quality Score, which lowers costs.
Optimizing for ROAS and revenue, not just CPA
Cost per acquisition treats every lead as equal. For a dental group, they are not. We optimized toward return on ad spend and revenue so the account favored higher-value treatments and patients who actually booked, instead of chasing the cheapest possible conversions.
Segmenting match types
We separated match types so the most precise, highest-intent searches were protected and funded properly, while broader discovery traffic ran with its own budget and tighter controls. This funneled traffic into the most relevant and cost-effective areas and made search term reviews far more productive, with negative keywords keeping irrelevant searches out.
Part two: a full-funnel approach to social media
A flexible structure for the algorithm
Meta’s ad delivery performs best when it has enough data in each campaign. Splitting budget into many tiny, location-by-location ad sets starves it. We consolidated into a flexible structure that gave the algorithm room to learn, while still reporting results by location.
Building quality first-party audiences
Rather than only targeting cold audiences with offers, we built a full funnel: reaching new people, then nurturing those who engaged, then converting warm audiences. Engaged viewers and site visitors became first-party audiences that are more valuable and more resilient to privacy changes.
Video storytelling
Dentistry is personal, and many patients are anxious. Video let us show the clinics, the people and the experience in a way static ads cannot, building trust before a patient ever calls.
Multi-touch attribution and value-based conversions
We used a multi-touch attribution model to understand which placements and stages of the Facebook funnel contributed to bookings, not just the last touch. We also set up value-based conversion actions, so the algorithm learned to find people likely to become valuable patients rather than anyone willing to fill in a form.
The results: better leads at a lower cost
The work delivered significant improvements in call duration, conversion rate, cost per click and cost per acquisition:
- 20% increase in PPC conversion rate
- 30% decrease in cost per call
- Better lead quality from social media
All of this came while maintaining or reducing the budget. For a group across 50+ locations, a lower cost per call and a higher conversion rate add up quickly, and better-quality leads mean front-desk teams spend their time on people who actually book.
Lessons for multi-location healthcare businesses
1. Measure quality, not volume
Track call duration, bookings and treatment value by location. Cheap leads that never book are not cheap.
2. Simplify the account structure
Fewer, better-organized campaigns help both people and algorithms make good decisions.
3. Optimize for value
Tell the ad platforms which outcomes are worth the most so they can find more of them.
4. Build audiences you own
First-party audiences from engaged prospects outlast changes to third-party data.
How to apply this to your group
- Track calls and forms by location, and record which become booked patients.
- Group keywords by funnel stage and treatment value.
- Match every ad to a location- and treatment-specific landing page.
- Consolidate social campaigns so each has enough data to learn.
- Feed booking or revenue values back into Google Ads and Meta.
FAQ
How do you manage ads across dozens of locations without wasting budget?
Use a clear, consistent structure with location-level tracking, so you can see which clinics need more patients and which are near capacity. Budgets can then be weighted toward where the demand and capacity are.
Is social media advertising worth it for dental practices?
It can be, especially for higher-value treatments where trust matters. A full-funnel approach with video and retargeting usually produces better-quality leads than single cold offers.
Why optimize for revenue instead of cost per lead?
Because not all leads are worth the same. Optimizing for revenue steers spend toward patients and treatments that grow the business.
Running marketing for multiple locations? See our PPC management, explore social media marketing or book a strategy call.
