How to Choose a Dental SEO Company: 10 Questions to Ask

Choosing a dental SEO company is mostly a matter of figuring out who is going to do real work and who is going to send you a report. Both look identical in a sales call. Both cost about the same. Only one of them fills chairs.

We've picked up plenty of practices after a bad agency year, and the pattern is always the same: nobody asked hard questions up front. So here are the ten questions we'd ask if we were the ones hiring — plus the answers that should make you nervous.

1. "What will you actually do in the first 90 days?"

You want a specific list: Google Business Profile cleanup, technical site fixes, service page builds, review system setup, tracking installed. Not "keyword research and content strategy."

Red flag: a plan that's mostly blog posts. Four blog posts a month will not move a practice that has a slow website and an unoptimized map listing.

2. "How will I know it worked?"

The only metrics that matter to a practice owner are new patient calls, form fills, and booked appointments — attributed to the channel that produced them. Rankings and traffic are diagnostics, not results.

What good looks like

• Call tracking with recordings, so you can hear the leads and audit how your front desk handled them
• Form and chat submissions tied to source
• A monthly number you can compare to what you're paying

Red flag: "we'll show you rankings and impressions." Impressions never paid for a hygienist.

3. "Who owns the website, the domain, and the tracking?"

You do. Always. Ask directly whether you keep the site if you leave, whether the domain is registered in your name, and who owns the call tracking numbers.

Red flag: proprietary platforms you can't export. Some agencies build on a locked template so leaving means starting over — that's a retention strategy, not a technology decision.

4. "Do you work with my competitors?"

An agency can't push two practices to the top of the same map pack. Ask for market exclusivity in writing, with a defined radius.

5. "Who is doing the work — and where?"

Ask who your day-to-day contact is, who writes the content, and who touches your Google Business Profile. Outsourcing isn't automatically bad; content written by someone who has never seen a treatment plan is.

Red flag: the person who sold you is the only person you'll ever talk to, or you can't get a straight answer about who does the work.

6. "How do you handle Google Business Profile and reviews?"

For most practices, the map pack drives more new patients than anything else on the site. So the answer needs detail: profile optimization, categories, services, photos, posts, Q&A, and a system for steady review velocity (this is the core of SEO for dentists done properly) with HIPAA-safe responses.

Red flag: anything involving buying reviews, gating negative reviewers, or writing them in-house. That's a suspension risk, and a suspended profile can cost you months.

7. "What's your plan for AI search?"

A growing share of patients now get an answer without clicking anything — Google's AI Overviews, ChatGPT, Gemini, voice assistants. Getting cited there depends on structured, specific, verifiable practice information: real service pages, schema markup, consistent details across the web, and content that answers actual patient questions.

If the agency has no view on this at all, they're selling you a 2019 playbook. This is the work we call generative engine optimization, and it runs alongside traditional SEO, not instead of it.

8. "Can I see results from a practice like mine?"

Not a logo wall — a case study with a starting point, a timeframe, and a new-patient number. Ideally a practice similar to yours in size and market competitiveness.

Red flag: guarantees. "Page one in 30 days" or a guaranteed number of new patients is either meaningless (page one for a term nobody searches) or a sign they'll chase easy wins that don't convert.

9. "What does the contract look like?"

SEO takes time, so some commitment is reasonable — but ask about term length, notice period, what happens to your assets at the end, and whether there's an early-termination fee. A 12-month term with a 30-day out after the first six months is fair. A three-year auto-renew is not.

10. "How much of my budget goes to actual work?"

Ask for a breakdown between management fees, content production, and ad spend if paid media is bundled in. You should be able to see where the money goes.

What legitimate dental SEO costs

• $1,500–$3,500/month for real SEO work in a typical competitive suburban market
• Below roughly $1,000/month, you're usually buying a template report, not labor
• Website builds and rebuilds are typically separate from the monthly retainer

The Five Fastest Ways to Disqualify an Agency

• Guaranteed rankings. Nobody controls Google.
• No tracking setup. If they can't attribute a call, they can't prove anything.
• You don't own your website. Non-negotiable.
• Reports without a phone call. A PDF is not a strategy conversation.
• Vague scope. "Ongoing optimization" means whatever they want it to mean.

A Sane Way to Run the Decision

Talk to three agencies. Ask all of them the same ten questions and write the answers down side by side. Ask each one what they'd fix first on your site and profile — the specificity of that answer tells you more than the whole pitch deck. Then check one reference from a practice that has been with them at least a year.

If you want a baseline before you talk to anyone, get an independent look at where your practice stands today: map pack presence, site health, and AI search visibility. That way you're evaluating proposals against reality instead of against each other.

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TL;DR

• Judge agencies on new patient calls and booked appointments, not rankings or traffic.
• Demand a specific 90-day plan; a plan made mostly of blog posts is a warning sign.
• You must own your website, domain, and call tracking — get it in writing.
• Ask for market exclusivity, a real case study from a similar practice, and a clear budget breakdown.
• Any agency without an answer for AI search (AI Overviews, ChatGPT) is running a 2019 playbook.
• Expect $1,500–$3,500/month for legitimate work. Guarantees, locked platforms, and three-year auto-renewals are disqualifiers.

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