BrightSmile Dental Filled 40+ Appointment Slots per Month with Local Ads

Context

BrightSmile Dental operates two dental practices in a mid-size European city. They offer general dentistry, cosmetic procedures, and orthodontics. Before working with us, they relied almost entirely on word-of-mouth referrals and a basic Google Business Profile.

They had tried running Google Ads internally with a small budget (€500/month) but results were poor — high cost per click, many irrelevant clicks from people outside their service area, and no call tracking to even know if ads were generating calls.

Funnel type: Local service lead generation (phone calls + online bookings) Average patient lifetime value: €1,200+ Target cost per new patient appointment: Under €50

Constraints

• Budget: Starting at €2,000/month, with willingness to increase if results proved out
• Tracking: No call tracking, no conversion tracking beyond the basic Google Ads click data
• Website: Functional but not conversion-optimized. No online booking integration initially
• Google Business Profile: Two listings, partially optimized, few recent reviews

Hypotheses & Experiments

Hypothesis 1: Local Service Ads will outperform standard Search for a dental practice

LSAs charge per lead (not per click), include a Google Guarantee badge, and appear above all other search results. For high-intent local searches like “dentist near me,” this should generate the best leads.

Experiment: We got both locations verified for Google Local Service Ads and launched alongside existing Search campaigns to compare lead quality and cost.

Hypothesis 2: Call tracking will reveal hidden performance

Without call tracking, there was no way to know which ads drove phone calls — the primary way patients book.

Experiment: We implemented call tracking with dynamic number insertion. Every ad, keyword, and campaign got trackable call attribution.

Hypothesis 3: Google Business Profile optimization and reviews will compound ad performance

A strong GBP with recent reviews increases Local Pack visibility and LSA competitiveness.

Experiment: We optimized both Google Business Profiles (complete services, photos, Q&A, posts) and implemented a review generation process asking happy patients to leave Google reviews after appointments.

Week-by-Week Progress

Weeks 1-2: Installed call tracking. Set up conversion tracking for calls (30+ seconds) and online booking form submissions. Applied for Google Local Service Ads verification. Weeks 3-4: LSA verification complete. Launched LSA campaigns for both locations. Restructured Search campaigns with tighter geographic targeting and call-focused ad extensions. Weeks 5-8: LSAs generating 15-20 calls per week combined. Cost per lead via LSA averaged €18 — far below Search which was at €45 per lead. Review count growing from 23 to 47 across both locations. Weeks 9-12: Search campaigns optimized based on call data — paused keywords that generated clicks but not calls. Budget shifted from Search to LSAs. Added Meta awareness campaigns for cosmetic dentistry services. Months 3-4: Steady state reached. 40+ new patient appointments per month. Budget increased to €3,000/month. Review count at 67+. Both locations appearing in Local Pack for all target keywords.

Results

Metric	Before	After (Month 4)	Change
New Patient Appointments/Month	8	42	+425%
Cost per Appointment	€95	€32	-66%
Phone Calls from Ads/Month	~12	85+	+350%+
Monthly Ad Spend	€500	€3,000	+500%
Monthly Revenue from New Patients	~€2,400	€12,600+	+425%
Google Reviews (combined)	23	67	+191%

What Did Not Work

• Broad keyword targeting in Search: “Dental clinic” without location modifiers attracted searches from the entire country. We had to add extensive negative locations and use phrase/exact match only.
• Meta Ads for general dentistry: Awareness ads for general check-ups did not generate meaningful bookings. People do not impulse-book a dentist from a Facebook ad. However, cosmetic dentistry (teeth whitening, veneers) DID work on Meta — it is more of an aspirational purchase.
• Evening and weekend ad scheduling without reception staff: We initially ran ads 24/7, but calls outside business hours went to voicemail and most of those callers never called back. We adjusted ad scheduling to match staffed hours.

Takeaways

1. Google Local Service Ads are the highest-ROI channel for local services. Pay per lead, not per click, with the Google Guarantee badge building trust. If your category is eligible, LSAs should be your first priority.
2. Call tracking is not optional for local businesses. Without it, you are guessing. With it, you know exactly which keywords and campaigns generate real phone calls.
3. Reviews compound ad performance. More reviews improve LSA ranking, Local Pack visibility, and click-through rates. Building a review generation process pays dividends.
4. Match ad schedule to business hours. Running ads when nobody can answer the phone is wasting money. Adjust schedules based on when staff are available to convert inbound calls.