[Byte Sized Podcast Ep. 65] Google Broke Dental Search Traffic. Paid Ads Are Now the Way Back In.

What You’ll Learn

The January Massacre

In January of this year, dental marketing companies watched their organic search traffic collapse.

Adrian Lefler was tracking over 1,100 keywords for My Social Practice. The company was outranking every competitor in the dental marketing space. Then January 21st hit. Google’s algorithm shifted, and from January through midsummer, search traffic across the dental industry tanked.

“I just watched the legs get chopped off out of everybody,” Adrian said on a recent episode of the Byte Sized Podcast. “It was rough for a lot of other companies that I talked to. A lot of CEOs were like, I don’t know what’s going on.”

Mitchell Leiman, CEO of iPromote, has spent more than a decade helping small and medium-sized businesses navigate digital advertising. He grew up in a small business family, worked at Bain & Company, then held leadership roles at Constant Contact, VistaPrint, and WordStream before leading iPromote. His explanation for what happened is simple. Google stopped being a waypoint and became a destination.

“It essentially became a page of links that you had to click on them, often many of them, and then you went somewhere,” Mitchell said. “Now it’s a destination. You usually start and end there versus before you were continuing your journey elsewhere.”

The Destination Problem

The AI overview at the top of Google’s search results now answers many queries directly. People get what they need without clicking through to a website. Total search volume is actually increasing. People are searching more than ever. But the traffic that leaves Google is shrinking.

“The volume that’s leaving Google to a destination is going down,” Mitchell said. “But search total search occasions is going up. We’re searching more and more.”

This creates a brutal reality for dental practices that depend on dental marketing and being found online. If Google’s AI doesn’t pull your information into the overview, you’re invisible to a growing percentage of searchers. They got their answer. They never saw your website.

The shift wasn’t malicious. Mitchell takes the positive view, saying that Google is trying to improve the experience for searchers. The old model of clicking through five sites to find an answer wasn’t great. Getting the answer directly is often better.

“I think they’re trying to improve the experience of the searcher,” he said. “Oftentimes it is a far superior experience as the consumer, as the searcher.”

But for businesses that relied on organic traffic, the experience improvement came at their expense.

Paid Ads Are More Important Than Ever

Adrian has spent years telling dentists not to spend $10,000 a month on SEO alternatives. Do the organic work. Build the foundation. That advice is shifting.

“I have said for years, don’t spend $10,000 a month. Do SEO,” Adrian said. “I am saying it now. I have to change my mind because I don’t think you’re going to be able to resist it. You’re going to have to spend money on ads if you want to be found.”

Mitchell agrees. Unless a practice has exceptional word of mouth and reputation, paid advertising for dentists is now the primary path to visibility for new patient acquisition.

“Paid advertising is probably more important now than ever for small and medium-sized business,” Mitchell said. “Organic visibility, if I don’t know you and I’m looking, paid ads is more important than ever.”

Emergency patients are the clearest example. Someone with a dental emergency probably hasn’t been to a dentist in years. They don’t know anyone to ask. They search, and if the AI says “here’s the emergency dentist you want to go see,” that doctor cleans up.

The foundation still matters. Google Business Profile, reviews, and dental website quality remain critical. But ads are now the fuel on top of that foundation, not an optional add-on.

What Is Performance Max?

Performance Max, known as PMax, is a Google Ads campaign type that works differently from traditional search campaigns.

In the old model, you picked specific keywords, set exact match types, controlled your bids, and managed every detail. Lots of knobs and dials. Today, PMax asks what you’re trying to accomplish, then takes your headlines, images, and video and decides where to place ads across Google’s properties: Search, Maps, YouTube, Gmail, Display, and Discover.

“You’re giving it assets,” Mitchell explained. “It’s not just your ad copy. It’s like here’s some images, here’s some video, here’s my style guide. And then you’re taking that on behalf of your client and you’re putting it into their account and you’re saying, all right, run with this.”

PMax is the main door Google has built for getting ads in front of patients inside or around AI overviews. In iPromote’s testing, dental ads have shown up around AI overviews but not directly inside them yet, though that could change any week.

The tradeoff is that you have less control. You can see how Google allocates your budget across channels now, but you can’t tell it to put 80% here and 5% there. The platform decides.

“The platform is designed to spend your money,” Mitchell said. “Sometimes you don’t have the feedback loop configured. Sometimes the learning is delayed or can’t happen because the volumes you’re running at aren’t sufficient.”

Big brands spending hundreds of thousands of dollars generate enough data to train the algorithm. A single dental office may not get enough conversions to learn effectively.

What Is AI Max?

AI Max is a setting on a standard search campaign, not a separate campaign type. Turn it on and it modifies your ads automatically.

It expands your keywords, matches searches to intent, and captures traffic you didn’t explicitly target. Mitchell gave an example: a campaign targeting “dentist near me” started capturing searches for a specific dentist’s name because AI Max decided that was the same intent.

“Your keyword is this, but what you really mean is this,” Mitchell said. “And so people that could search for very different phrases, it’s going to capture that.”

However, AI Max doesn’t give recommendations. It makes changes. Until recently, advertisers had no visibility into what it was doing. Google just added the ability to see illustrative examples of AI Max changes, but you still don’t have full transparency or control.

“It’s doing it,” Mitchell said. “And sometimes it’s doing it really well. Sometimes it’s not. You don’t have a lot of control over it.”

How Much Should a Dental Practice Spend?

Mitchell offered two frameworks for thinking about ad budgets.

Top down: Spend 3% to 7% of revenue on marketing. For a million-dollar practice, that’s roughly $30,000 to $50,000 a year, or $2,000 to $3,500 a month on digital ads.

By patient value: You can afford to spend about a quarter to a third of what a new patient is worth to acquire one. If a new patient is worth $1,200 to your practice, you can spend $300 to $400 to get them.

For a $3,000 monthly budget, Mitchell recommends allocating across search and social, with about 70% of the search portion going to traditional search campaigns and 30% to PMax.

The minimum budget question comes up constantly. Many marketers say you need at least $1,500 a month to generate enough data to train the algorithm. Mitchell acknowledges that you might need 30 or 50 conversions to learn effectively. At smaller budget levels, the spend happens but probably not optimally.

The Foundation Still Matters

Paid ads work best on top of a solid foundation. Google Business Profile, reviews, and website quality are still critical inputs that affect how Google evaluates your practice.

“What’s still incredibly important is that foundation of your Google Business Profile, your reviews, your website,” Mitchell said. “Those are still really important to get right. And then ads are going to be the fuel on that foundation.”

Adrian has a multi-hour presentation on what dentists need to do to be found by AI search engines. He doesn’t talk about ads in it. By the end, doctors are drained because the checklist is a hundred tasks long.

“Most doctors are not going to want to do the tasks,” Adrian said. “They’re probably not going to want to hire a marketing company or an internal person to do it. They may not have the budget. And so ads become the obvious solution to breaking through the noise and being found in the search engine.”

The organic work matters. But ads have become the practical path to visibility for practices that can’t execute a hundred-item SEO checklist.

ChatGPT Ads: Worth Experimenting?

The New Reality

In This Episode:

Mitchell Leiman, CEO of iPromote

Mitchell Leiman is the CEO of iPromote, a digital advertising platform that helps partners manage paid advertising for small and medium-sized businesses. Before iPromote, he was a consultant at Bain & Company and held leadership roles at Constant Contact, VistaPrint and WordStream. He grew up in a small business family and has spent more than a decade helping small advertisers succeed online.

Adrian Lefler, CEO and Co-founder of My Social Practice

Adrian Lefler, CEO of My Social Practice, is a seasoned expert in the dental marketing industry with 14 years of experience. He is widely recognized for his engaging and informative presentations. Based in Suncrest, Utah, Adrian shares his life with his wife, four children, and a lively mix of pets. My Social Practice is a leading dental marketing company, and Adrian is passionate about helping dental professionals succeed in this dynamic field.