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When dental practices come to us after leaving another agency, the reason is rarely that rankings dropped. It is that after six months they still could not tell what they were paying for. The reports are full of charts, the phone is not ringing more, and nobody can explain what was actually done.
Almost all of that can be avoided before you sign. Google even publishes its own list of questions to ask before hiring an SEO. This guide takes those questions, adds the ones that matter specifically for dental practices, and shows you what a good answer and a bad answer sound like.
First, know what you are buying
"Dental SEO" is not one service. It is a set of work that, done together, makes your practice easier to find and easier to choose on Google. A complete engagement usually covers:
- Google Business Profile setup and ongoing management, which drives your Map Pack visibility
- Website and on-page SEO: service pages, location pages, titles, internal links
- Technical SEO: site speed, indexing, crawl errors, structured data
- Content that answers the questions patients ask before booking
- Reviews and reputation: a system for getting and responding to reviews
- Local links and citations from real, relevant sources
- Reporting that ties the work to calls and booked appointments
If an agency is only offering one or two of these, that is not necessarily wrong, but you should know which pieces are missing and who will cover them. For a deeper look at the local side, see our local SEO guide for dentists.
12 questions to ask a dental SEO company
Can you show me dental practices you have helped, and can I talk to one?
Google lists "Can you show me examples of your previous work?" as the first question to ask any SEO. For a dental practice, the examples should be dental practices, with real numbers: calls, Map Pack positions, organic traffic, new patients.
Good answer: specific case studies, named clients where they have permission, and a reference you can call. Red flag: vague claims like "we have helped hundreds of businesses" with nothing you can verify.
Do you work with other dental practices in my area?
This matters more in dental SEO than in most industries. The Map Pack shows three practices, and Google ranks local results partly on distance from the searcher. Two practices a mile apart are competing for the same three spots. An agency working for both has a built-in conflict of interest.
Good answer: "We work with one practice per market," or a clear explanation of how they avoid overlap. Red flag: "Yes, we have five practices in your city," with no answer to how they decide who ranks first.
Who owns my Google Business Profile, website, content, and data?
This is the most important question on the list, and the one practices most often forget to ask. Your Google Business Profile has one primary owner, and Google allows owners and managers with different permissions. Your agency should be a manager. Your practice should be the primary owner.
The same applies to Google Search Console, where a verified owner has full control over the property, and to Google Analytics. These accounts should be in your name, with the agency given access.
Good answer: "You own everything: the profile, the website, the content, and all accounts. We get access, and you can remove it anytime." Red flag: the agency creates accounts under its own name, or the website is built on a platform only the agency can access.
What will you do in the first 90 days?
A good agency starts with an audit, not with content or links. Before anything else, they should know what is broken on your profile and website, how your competitors are positioned, and which services bring the most value to your practice.
Good answer: a clear sequence, usually audit, then fixes to the Business Profile and technical issues, then service pages and content. In 2027, the plan should also cover how your practice appears in AI answers, not only in the classic results. Red flag: "We start publishing four blog posts a month right away," before anyone has looked at your site.
How do you build links?
Links still matter for rankings, but how they are earned matters more. Buying links, or exchanging goods or services for links to manipulate rankings, is link spam under Google's policies, and it can hurt the practice long after the agency is gone.
Good answer: local sponsorships, community involvement, dental associations, local media, and relevant directories. Red flag: "We will get you 200 backlinks a month," or any package priced per link.
What results should I expect, and when?
Google is direct about this: no one can guarantee a #1 ranking. An honest agency will give you a realistic range based on your market, your starting point, and their experience with similar practices.
Good answer: "Profile and technical fixes usually show early movement. Competitive services in your city will take longer. Here is what similar practices saw." Red flag: "Page one in 30 days, guaranteed."
What will you report on, and how often?
Rankings and traffic are useful, but they are not the goal. The goal is new patients. A monthly report should show calls from Google, direction requests, website bookings, and how those compare to last month and last year.
Good answer: a monthly report focused on calls and bookings, with a call to walk through it and agree on next steps. Red flag: a 40-page automated PDF full of keyword positions and no explanation of what changed or why.
Who will I talk to, and how quickly will they respond?
"How can I expect to communicate with you?" is on Google's own list of questions. You should know who your main contact is, how to reach them, and how fast they typically reply.
Good answer: a named person who knows your account, a regular call, and a clear response time. Red flag: a support ticket system and a different person every month.
Who actually does the work?
Many agencies resell SEO done by other companies, often called white label SEO. That is not automatically a problem, but you should know who is touching your website and Business Profile, and whether they understand dental practices.
Good answer: a straight answer about who does what, and the ability to speak with the person responsible for your SEO. Red flag: reluctance to say who does the work. Google also warns against SEOs who will not clearly explain what they do.
How long is the contract, and what happens if I leave?
SEO takes time to show results, so a minimum term of around six months is common and reasonable. What matters is what happens at the end of it.
Good answer: a clear minimum term, then month-to-month, and a clean handover when you leave: all logins, all content, all reports, and the website stays yours. Red flag: a long lock-in with high cancellation fees, or an agency that "turns off" your website or keeps your Business Profile when you cancel.
Will you sign a business associate agreement if you handle patient data?
This one is specific to US healthcare. If an agency creates, receives, or stores protected health information on your behalf, it may be a business associate under HIPAA, and you need a business associate agreement (BAA) in place. In SEO work, this can come up with form submissions, call recordings, or chat tools on your website.
Good answer: the agency understands the question, explains what patient data (if any) it will touch, and signs a BAA where one is needed. Red flag: "HIPAA does not apply to marketing," with no further explanation.
How do you handle reviews?
Reviews are one of the factors Google uses for local rankings, which is why some agencies take shortcuts. The FTC's 2024 rule bans fake reviews and incentives tied to positive or negative reviews, and Google's own policies prohibit offering incentives for reviews at all.
Good answer: a system that makes it easy for real patients to leave reviews, plus professional, privacy-safe replies. Red flag: any offer to "generate" reviews, or to reward patients with discounts in exchange for them.
Red flags that should end the conversation
Some answers are enough to walk away on their own:
- A guaranteed #1 ranking or "page one in 30 days"
- A claimed "special relationship" with Google
- An unsolicited email promising top rankings for your practice
- Suggestions to add keywords or city names to your Google Business Profile name, which Google's guidelines prohibit and which can get the profile suspended
- Link packages priced per link
- Accounts, profiles, or the website set up in the agency's name
- No dental case studies, or none they can show you
- Reports that show rankings and traffic but never calls or bookings
A quick scorecard for comparing agencies
If you are talking to two or three agencies, score each one on the questions that matter most:
| Area | What you want to hear | Walk away if |
| Proof | Dental case studies with real numbers and a reference | Only vague claims |
| Conflicts | One practice per market, or a clear policy | Several competitors in your area |
| Ownership | You own the profile, site, content, and data | Accounts in the agency's name |
| Method | Audit first, then fixes, then content and links | Links sold by the hundred |
| Expectations | Realistic ranges based on your market | Guarantees |
| Reporting | Monthly, focused on calls and bookings, with a call | Rankings only, no explanation |
| Contract | Clear minimum, clean exit | Lock-in, penalties, hostage assets |
How we answer these questions at Nadma
Since we are asking you to hold agencies to this standard, here is how we answer the same questions:
| Question | Our answer |
| Proof | Our case studies show real results, for example GlowDent reaching 1,000+ organic clicks a month within 12 months, and Cvijetić Impladent getting 6 core procedures into the Map 3-pack with 80% more new patient calls in six months. |
| Other practices in your area | We work with one practice per market. |
| Ownership | You own everything: your Business Profile, website, content, Analytics, and Search Console. |
| Contract | Six-month minimum, because that is how long it takes to see meaningful results. |
| Reporting | A monthly report on rankings and Business Profile performance on every plan. From the Growth plan up, the report also includes call and lead tracking, and the Pro plan adds a quarterly strategy call. |
| Pricing | Published openly on our pricing page. |
Frequently asked questions
Is a dental-only SEO company better than a general SEO agency?
Not automatically, but it usually helps. A dental-focused agency already knows which services drive revenue, how patients search for them, and the privacy rules around reviews and patient data. Google itself suggests asking about experience in your industry.
How much does dental SEO cost?
It depends on your market and how competitive your services are. A single-location practice in a smaller city needs less than a multi-location group competing for implants in a large metro. Be cautious of very cheap packages, which usually mean automated work or low-quality links. You can see how we structure our plans on our pricing page.
Can I switch SEO agencies without losing my rankings?
Yes, if you own your accounts and your website. Rankings belong to your website and Business Profile, not to the agency. Problems happen when the agency owns the profile or hosts a site you cannot take with you, which is why question 3 matters so much.
How long before I see results from dental SEO?
There is no fixed timeline, and nobody can honestly guarantee one. Business Profile and technical fixes can show movement early, while ranking for competitive services in a busy market takes longer. Ask each agency to show you what similar practices achieved and over what period.
Before you sign
Take this list into every agency call. The right partner will answer all 12 questions clearly and without getting defensive. If you want to see how your practice stands before talking to anyone, request a free dental SEO audit. You can also read more about how we work.
