Orthodontic marketing pays off on starts, not on consults booked or likes earned, and a second count matters just as much: observation patients too young to start who may sign years later. Track both pipelines by source, alongside every general dentist who sends you a patient.
Quick answer
- Log every consult's source, then mark it a start only once the contract is signed and a down payment taken. Judge Google Ads, Meta ads, your Google Business Profile (the free listing in Google Search and Maps) and every referring dentist's office by starts, not consults.
- Give observation patients (children not ready yet) their own list with a recall date, so the source that brought them in survives until they finally start, possibly years later.
- Name each referring general dentist's office in your source field, not a single "referral" bucket, and pull a monthly starts count per office.
- Keep teen and adult campaigns apart, and write the teen ones for the parent who signs the contract. Google turns off ads personalization for under-18 accounts, and Meta reaches teens by age and location only.
- Don't expect Google Ads to credit a start that comes more than 90 days after the ad click. Observation patients start years later, so your practice software, not an ad platform, has to carry the link.
What counts as a start, and why doesn't a consult?
A start is the point where a free consult becomes a signed contract with a down payment, the moment the practice actually has revenue. A consult only tells you someone showed up and heard a treatment plan. A consult can end in "let me talk to my spouse," and in orthodontics it can also end in "not yet," because a child isn't ready for treatment. A consult count hides those outcomes; a start count shows them.
Set up three fields in your practice software that every front-desk or treatment-coordinator entry has to touch: source (where the lead came from), consult date, and start date if one happens. A channel, or a referring dentist, that fills your consult calendar but produces few starts is costing coordinator time, not just ad spend.
Why does an observation patient need a pipeline of her own?
The American Association of Orthodontists recommends a child complete a first check-up with an orthodontist by age 7, when the mix of baby and permanent teeth gives the orthodontist a lot of information (AAO, checked 2026-10-05). A child seen at 7 may not be ready to start that day. The AAO describes the follow-up as observation visits, often scheduled once or twice a year, that let the orthodontist track growth and decide when treatment should actually begin (AAO, checked 2026-10-05).
If that first visit's source gets marked "consult, no start" and closed, the marketing credit for the eventual start, years later, disappears. Keep observation patients on their own list with a next-recall date and the original source untouched, so a child who first came in through a Google Ads click in 2024 can still show "Google Ads" as her source the day she starts in 2027.
Why does a referring dentist deserve a tracked line of its own?
A general dentist who notices crowding at a cleaning and sends a patient your way is a source like an ad channel, except the patient arrives on another dentist's word. Give every referring office its own entry in the source field, by name, the same way general practices track their own referral source. A lump "referral" category tells you referrals exist; a named list tells you which offices deserve a thank-you call and which one has gone quiet.
Pull the same two numbers for referring offices that you pull for paid channels: consults sent and starts that followed, by month. An office whose few consults nearly all start can matter more than one that sends many consults and few starts.
Who is actually searching when the patient is a minor?
Google doesn't allow ads personalization (choosing ads from what Google knows about the person rather than from the search or page) on the Google Accounts of users under 18 (Google, checked 2026-10-05). Meta says age and location are the only information about a teen it uses to show them ads on Facebook and Instagram, with gender removed as an option (Meta, checked 2026-10-05).
Meta's Health and Wellness standard also requires ads for cosmetic procedures to target people 18 or older; it names no orthodontic treatment (Meta, checked 2026-10-05), so whether an aligner ad counts is Meta's call at review. Either way, for a minor's braces the parent signs the contract and pays. Write braces campaigns for that parent, not for a teenager scrolling.
Should adult aligner and teen braces searches share a campaign?
Adults search for their own treatment and decide for themselves; parents search for a teen and decide for the family. Keyword Planner puts a generic patient search next to the search agencies use to find practices like yours:
| Search | US searches a month | Average CPC | Top-of-page bid range |
|---|---|---|---|
| braces near me | 40,500 | $20.43 | $3.54 to $24.97 |
| orthodontic marketing (owner search) | 260 | $37.36 | $12.00 to $35.01 |
(Google Ads Keyword Planner estimates for the US, October 2026: averages for the whole country, not what you'll pay locally; the second row is advertisers bidding to reach practice owners like you, shown only for context.)
A parent typing "braces near me" for a child and an adult comparing clear aligners for themselves want different answers: who wears it, how it looks, how long it takes, who pays. The dental implant marketing guide follows another adult buyer deciding on an elective treatment. Run separate campaigns, landing pages and ad copy for the two; a page built around "your teen's smile" wastes the adult click, and the reverse wastes the parent's.
Why does Google's conversion window lose the observation patient?
Google's click-through conversion window (how long after an ad click Google will still credit a result to that click) can be set from 1 day up to 30, 60 or 90 days for Search and Display, depending on where the conversion comes from. The default is 30 days, and a result that arrives after the window isn't recorded (Google, checked 2026-10-05). A parent who clicked an ad when her child was 7, for a start at 11, is years past any window Google offers. No offline conversion upload (sending results from your own records back to Google Ads) can tie that start to the original click.
That's not a tracking failure to fix. The link has to live in your practice software: a start report pulled from your own records, keyed to the source logged at the very first visit, is the only place it survives.
What did one illustrative year of consults and starts look like?
Illustrative: every number below is made up, for a fictional single-doctor orthodontic practice, and none comes from a client.
| Patient type | Who decides | Typical path (this illustrative practice) | What to count |
|---|---|---|---|
| Teen, ready now | Parent | Consult at 11, start within weeks | Starts by source, this month |
| Teen, observation | Parent, years later | Added to the list at 7, recall visit twice a year, starts at 11 | Observation adds and recalls kept; starts traced back years later |
| Adult, self-referred | Adult patient | Searches at night, consults, starts the same month or the next | Starts by source, this month |
| Referred by a general dentist | Parent or adult, prompted by the dentist | Dentist mentions it at a cleaning, patient calls direct, consults, starts | Starts by referring office's name, monthly |
Over the year, Google Ads brought 140 consults and 42 starts, for a start rate of 42 ÷ 140 = 30 percent, at an ad spend of $18,900, so $18,900 ÷ 42 = $450.00 per start. The practice's 12 referring general dentists together sent 95 consults and 51 starts, a 51 ÷ 95 = 54 percent start rate, with no ad spend behind it. The Business Profile brought 80 consults and 19 starts, a 19 ÷ 80 = 24 percent start rate.
Separately, 14 children added to the observation list in earlier years started treatment this year. Their first visits, and the sources logged there, would have been closed out as "no start" long before this year's count ran. Adding them, the practice's starts for the year were 42 + 51 + 19 + 14 = 126, and 14 of those, about 11 percent, would have been invisible to any report that only looks at this year's consults.
How do you log it so the numbers hold together?
- One source field, filled at the first visit, never blank: an ad channel, "Business Profile," or the referring dentist's name.
- One status field with three values: consult, observation, start. A patient can sit in observation for years before moving to start; nothing closes that chart as lost.
- A recall date on every observation record, following the once- or twice-a-year rhythm the AAO describes, so no observation patient ages out unnoticed.
- A monthly pull, by source, of consults, starts, and the start rate (starts ÷ consults), run alike for referring dentists and ad channels.
What to ask your agency or software vendor
- Does the source field in the practice software support a named referring-dentist list, not a single "referral" option?
- Can a patient sit in an observation status for years without closing the record or losing the original source?
- What counts as a "lead" in your monthly report: a call of any length, a form, or an actual consult booked?
- If starts get uploaded to Google Ads as offline conversions, which ones fall inside the 90-day window, and which, like observation starts, never will?
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Frequently asked questions
What counts as a start in orthodontic marketing, and why not a consult?
A start is a signed treatment contract with a down payment taken, the point where a consult turns into revenue. A free consult only shows that someone walked in, and it can end in 'let me think about it' or 'not ready yet.' Judge every channel, including each referring dentist, on starts per month, not on consults booked.
Why do observation patients need a separate pipeline from active starts?
A child seen at the first check the American Association of Orthodontists recommends by age 7 may be years from being ready to start, so closing that chart as lost loses the eventual start too. A separate observation list with its own recall schedule keeps the child's original source attached until the day treatment begins.
Can I target teenagers directly with Google or Meta ads?
Only narrowly. Google doesn't allow ads personalization on the Google Accounts of users under 18. Meta uses only a teen's age and location to show ads on Facebook and Instagram. For a minor's braces, the parent signs the contract and pays, so write the campaign for the parent.
How do I find out which referring dentist sends me the most starts?
Give each referring general dentist's office its own line in your practice software's source field, by name, not a single 'referral' bucket. Pull a monthly count of consults and starts per referring office, the same way you would for an ad channel.
At what age does the AAO recommend a child's first orthodontic visit, and does that change how I market to parents?
The American Association of Orthodontists recommends a child complete a first check-up with an orthodontist by age 7, when the mix of baby and permanent teeth gives the orthodontist a lot of information. That recommendation is the reason to market observation checks to parents of 6- and 7-year-olds separately from the braces or aligner searches parents of young teens run.
Written by
Alexander Cheberko
Marketing Analytics & Conversion Tracking Engineer, NYC-focused, run remotely
- Media buyer on Google Ads and Meta Ads from October 2023 to September 2025, nearly $700K in spend.
- Set up patient conversion tracking for a New York medical practice (anonymized).
- Upwork Top Rated, 5.0 from 20 reviews.