In this episode of the Dental Marketing Mix, DentalScapes co-founder Dan Brian breaks down one of the most urgent issues affecting dental practices right now: Google reviews are disappearing — and not just suspicious ones. Five-star reviews that practices worked hard to earn are being removed at record rates, and the review strategies a lot of front desks have been running for years may now be making things worse. Dan covers what’s driving the removals, what Google’s updated policies actually prohibit, and how to build a review program that holds up going forward.
What’s Happening — and Why It’s Different This Time
Starting in late January and accelerating through February of this year, practices across the country started noticing their review counts dropping overnight, with no warning and no explanation from Google. Industry experts documented thousands of businesses affected, and dental and medical practices were specifically flagged as one of the categories seeing a disproportionate share of removals.
As Dan notes, what makes this wave unusual is who’s being hit: “We’re not talking about one-star reviews getting flagged. We’re talking about five-star reviews — reviews you earned — just gone.”
Some of what happened is a technical glitch that Google is still working through. But Dan is clear that a significant portion of the removals are intentional — the result of Google’s AI-powered moderation getting smarter. And here’s the part that catches most practices off guard: Google’s system isn’t just evaluating new reviews. It’s retroactively re-evaluating reviews that were posted months or even years ago. If those older reviews now match patterns the algorithm considers suspicious, they get pulled. A genuine five-star review a patient left in 2023 can disappear in 2026.
Around the same time the removals started, Google also quietly updated the review policy section of their Google Business Profile guidelines. No announcement. Just a policy change — and a lot of practices had no idea until their counts started dropping.
What Google’s Review Algorithm Flags as Suspicious
Dan walks through the three main patterns that trigger Google’s moderation system.
Sudden volume surges. If your practice averages five reviews a month and suddenly gets forty in a two-week window, that spike looks like coordinated behavior to the algorithm — regardless of whether those patients are completely real. Dan says this is one reason “review campaigns” where you blast your entire patient list at once can backfire, even when the ask itself is totally legitimate.
Thin reviewer profiles. Google looks at the person leaving the review, not just the review itself. If a high percentage of your reviewers have little other activity on Google — no other reviews, no Maps contributions, a new account — that’s a signal. One or two inactive reviewers in a month probably won’t move the needle. But if it’s a consistent pattern, it will.
Shared device patterns. This one surprises a lot of practices. If you’ve had a tablet at the front desk where patients can leave reviews on the spot, you may have inadvertently generated multiple reviews from the same device and IP address. Dan explains that to Google’s system, that looks like one entity gaming the review count — even if six different patients used your iPad on six different days.
Why This Matters Beyond Your Star Rating
Dan is direct about what’s actually at stake here. Reviews aren’t just a social proof tool that helps prospective patients feel confident before booking. They’re a direct ranking signal in local search.
“When Google decides which dental practice to show someone searching ‘dentist near me,’ the quantity, recency, and consistency of your reviews factors into that decision. When you lose reviews, you’re not just losing stars. You’re potentially losing ground in local rankings, which means losing visibility, which means losing new patient inquiries.”
He also emphasizes that velocity matters — Google rewards practices that generate reviews consistently over time, not practices that had a lot of reviews two years ago. A steady review program, Dan says, isn’t just reputation management. It’s long-term SEO infrastructure.
What You Cannot Do Under Google’s Updated Policies
Dan walks through the most common violations, some of which have caught practices completely off guard.
- Offering incentives. No discounts, no gift cards, no free whitening — nothing tied to the ask. The incentive itself is the violation, regardless of whether you’re asking for a positive review or just any review.
- Review gating. This is the mistake Dan says he sees most often, and many practices don’t realize they’re doing it. Review gating is when you pre-screen patients — routing happy ones to Google and unhappy ones to an internal feedback form. It seems like smart reputation management, and until recently many software platforms were built to do exactly this. But Google’s updated policy now explicitly prohibits selectively soliciting positive reviews. Every patient needs the same opportunity to leave a review, regardless of how you think their experience went.
- In-office pressure. Asking patients to leave a review before they’ve even gotten to their car is now a policy violation — including verbal pressure at checkout, signs at the front desk, and the shared-device tablet setup.
- Coaching patients on what to write. Telling someone to “mention Dr. Smith by name” or to “say something about your Invisalign consultation” is against the rules. The review has to reflect a genuine, unprompted experience in the patient’s own words.
What You Should Be Doing Instead
The good news, Dan says, is that Google isn’t anti-review. They’re anti-manipulation. There’s a lot you can do — and should be doing consistently.
- Ask every patient. Not just the ones you think are happy. Send the request after they’ve left the office, by email or text, a few hours to a day or two after their appointment. Keep it simple, warm, and include a direct link to your Google review page.
- Respond to every review — positive and negative. Dan calls this one of the most underrated actions a practice can take right now. Responding signals to prospective patients that you’re engaged and that you care. It also creates a timestamped record of real engagement that works in your favor if you ever need to appeal a removal.
- Monitor your profile at least weekly. If you notice a sudden drop, document it — screenshots, dates, review counts. You can submit an appeal through the Google Business Profile Help Center, though Dan notes that reinstatement isn’t guaranteed.
- Audit your review software. Some platforms that were compliant six months ago may now be facilitating review gating or using solicitation patterns Google flags. It’s worth taking a fresh look at exactly what your software is doing on your behalf.
The Bigger Principle: Process Over Campaigns
Dan closes with what he calls the bigger principle behind all of it. The practices that weather Google’s ongoing policy changes aren’t the ones who sprinted to five hundred reviews in six months. They’re the ones who built consistent, policy-compliant programs and stuck to them.
“Eight to fifteen reviews a month, month after month, looks legitimate because it is legitimate. That’s the signal Google trusts. And it’s what earns you ranking stability over the long term.”
He frames it simply: not a campaign. A process. Consistent asks, every patient, every time, through a clean workflow. Build that, and your review profile becomes a durable asset. Take shortcuts, and you’re always one algorithm update away from losing ground.
TL;DR
- Google reviews are disappearing at record rates — including five-star reviews — due to a combination of a technical glitch and increasingly aggressive AI-powered moderation
- Google is retroactively re-evaluating old reviews; a review from 2023 can be removed in 2026 if it now matches suspicious patterns
- The three main triggers are sudden volume surges, thin reviewer profiles, and shared device/IP patterns (like a front-desk tablet)
- Reviews are a direct local search ranking signal — losing them can mean losing visibility and new patient inquiries, not just stars
- You cannot incentivize reviews, practice review gating, pressure patients in-office, or coach patients on what to write
- You should ask every patient (after they leave), respond to every review, monitor your profile weekly, and audit your third-party review software for policy compliance
- Consistent velocity — eight to fifteen reviews per month, every month — is more durable and more trusted by Google than any burst strategy
- Build a review process, not a review campaign
Ready to Build a Review Program That Actually Holds Up?
If you’re not sure whether your current review strategy is compliant with Google’s updated policies — or you want help building a process from scratch that’s sustainable and consistent — that’s exactly the kind of thing we work through with dental practices at DentalScapes.
Book your free strategy call with DentalScapes today and we’ll take a look at where you stand and what needs to change.