How to Audit Your Dental Marketing Agency: 12-Point Checklist (2026)

Short answer: a good dental marketing agency lets you own your ad accounts, bills ad spend separately from its fee, tracks booked patients rather than clicks, and can show you exactly which searches your money paid for. If you cannot confirm at least 8 of the 12 checks below in an hour, you are paying for activity you cannot verify.

Key takeaways

Google's own policy requires agencies to give you your Google Ads customer ID on request and to show their management fee separately from ad costs.
The most common waste we find is in the search terms report: clicks from job seekers, DIY searches and other cities.
Leads are not patients. Ask for booked new patients by month, and check how many calls your office actually answers.

What do you need before you start?

Gather three things: your login to Google Ads (or the customer ID, a 10-digit number), your last three agency invoices, and your last three monthly reports. If you do not have a Google Ads login at all, that is your first finding.

The 12-point dental agency scorecard

Tick each check you can confirm today. Your answers are saved in this browser so you can come back to it.

Checks 1 to 4: who owns what, and where the money goes

Do you own your Google Ads account?

Log in to Google Ads with your own email, then open Admin, then Access and security. You should see yourself as an Admin user and the agency as a linked manager account or a Standard user. Only Admins can remove access, so read-only access is not ownership.

Google's third-party policy requires agencies to give you the customer IDs for your Google Ads accounts when you ask. If your agency hesitates, ask in writing.

Can you see what you paid Google, separately from the agency?

The same policy requires agencies that charge a management fee to tell you, and to report the exact amount Google charged with their own fees excluded. Put an invoice next to Google Ads Billing for the same month. The ad spend figures should match.

If the agency funds the ads from its own account and bills you one combined number, you cannot check either figure. This is the setup most likely to hide a markup on ad spend.

Checks 5 to 7: is tracking measuring patients or just activity?

In Google Ads, open Goals, then Conversions, then Summary. Look at which actions are marked Primary. These are what the campaign is optimized for and what your report calls leads.

Then ask for one number: how many new patients booked from ads last month. If the agency cannot answer, the gap is usually tracking, not effort. Our guide to offline conversion tracking for dental practices explains how to close it without an expensive CRM.

Checks 8 to 11: is the ad money going to the right searches?

In Google Ads, open Campaigns, then Insights and reports, then Search terms, and set the date range to the last 90 days. Sort by cost. Read the top 50 searches and mark anything a new patient would never type.

What we found in one account

$83.59cost per enquiry before

$10.39after the rebuild

15 → 423enquiries, same practice

At The Smile Designer in Spring, Texas, much of the budget was going to searches that would never book. Rebuilding the account around what patients actually search for cut the cost per enquiry by 88%. Read the case study.

While you are there, check location settings under Campaign settings, then Locations, then Location options. "Presence: people in or regularly in your included locations" is usually right for a dental office. The broader option can spend money on people researching your city from elsewhere.

Check 12: what happens when the phone rings?

Most dental leads arrive by phone, so call handling decides how much of the ad budget turns into patients. In a February 2026 study of 4,280 calls to 26 dental offices, Peerlogic found that 38% of calls went unanswered, and only about 25% of new-patient calls booked an appointment.

Ask your agency for call recordings, or listen to five yourself. If calls go to voicemail at lunch or after 4 pm, changing staffing or adding call-back rules will often do more than any change to the ads.

What should you do with your score?

Score	What it means	Next step
11 to 12	The fundamentals are in place	Ask for cost per booked patient by channel and set a target
8 to 10	Mostly sound, with gaps	Fix the unchecked items within 30 days, ownership and tracking first
5 to 7	Weak	You are paying for activity you cannot verify. Request a plan in writing.
0 to 4	Red flags	Get Admin access to your accounts before you change anything else

If you decide to switch, do it in this order: secure Admin access to Google Ads, your Business Profile and your domain; download reports for the past 12 months; then give notice. Our page on month-to-month dental marketing covers what fair contract terms look like, and our dental marketing cost guide shows what you should be paying.

Frequently asked questions

How do I know if my dental marketing agency is doing a good job?

Check that you own your ad accounts, that invoices separate ad spend from fees, and that reports show booked patients rather than clicks. Then compare your cost per lead with the 2026 dental median of $72.97 for search ads.

Should I own my Google Ads account or should my agency?

You should. Google's third-party policy requires agencies to give you your customer ID on request. With Admin access you keep your account history if you change agencies.

What reports should a dental marketing agency send each month?

At minimum: spend, leads and cost per lead by channel; calls with recordings; booked new patients; and the main changes made that month and why.

How often should I audit my dental marketing?

Run this checklist once a quarter, and whenever leads or booked patients drop for two months in a row.

Can I audit my agency without access to the ad account?

Only partly. Without access you can check invoices, your website and your phones, but not the search terms, conversions or settings. Getting access is the first fix.

Sources

Abdullah AsimFounder, The Dental Marketing Firm

Abdullah audits and runs Google Ads accounts for dental practices and wrote this checklist from the issues he finds most often. The Dental Marketing Firm works only with dental practices, from 3925 W North Ave, Chicago.