A Boston cosmetic and general dental practice burning $12K monthly on ads
A single-location cosmetic and general dental practice in the Back Bay neighborhood of Boston. The practice had been open since 2017 with a strong clinical team, but their marketing budget had ballooned to $12,400 per month with diminishing returns. The owner dentist was the sole decision maker and had run through 3 marketing agencies in 4 years before reaching out to Elatre on a referral from another Boston healthcare client.
Why their cost per lead kept climbing
The practice had a cost per lead of $147, up from $89 two years earlier. Google Ads were broad-matched across generic dental terms, competing for traffic with national chains and DSO-backed practices that could outspend a single location. Their website had a single contact form on a generic homepage, with no neighborhood signal, no cosmetic-specific landing pages, and no video content. The Google Business Profile had 142 reviews but had not been actively managed in 16 months, so newer reviews from disgruntled patients sat at the top of the listing.
How we rebuilt the funnel around Back Bay buyers
We pulled the Google Ads spend down by 35% in the first 30 days, while restructuring the account into 5 hyper-targeted campaigns covering invisalign, veneers, dental implants, emergency dentistry, and family preventive care. Each campaign sent traffic to a custom landing page with neighborhood-specific signal (Back Bay, South End, Beacon Hill, Cambridge) and dentist bios with real photos. We produced 14 short videos covering common patient questions, with the lead dentist on camera in the practice. The videos ran on YouTube ads, embedded into landing pages, and were syndicated through Google Business posts. On the local SEO side, we set up a weekly review response cadence and a 72-hour post-visit SMS request flow that surfaced 84 new 5-star reviews over the engagement.
Six months later: leads, cost, and case mix
By month 6, cost per new patient lead had dropped to $38, on a reduced ad budget of $8,100 monthly. Monthly new patient inquiries grew from 84 to 412. Google Business Profile views grew from 4,800 to 38,900 monthly. Google review count moved from 142 to 309, with average rating rising from 4.6 to 4.9 stars. Critically, the case mix shifted: cosmetic case bookings grew from 6 per month to 41 per month, since the new campaigns directed cosmetic-intent buyers to dedicated pages instead of the homepage. Average new patient lifetime value increased by approximately $1,800 because the funnel now attracted higher-intent cosmetic patients earlier in their decision cycle.
Why the dentist stopped switching agencies
The practice had hired and fired 3 agencies in 4 years before working with Elatre. The combination of local intent, video proof, transparent dashboards, and direct access to senior leads kept the engagement on a 24-month renewal. The dentist now refers Elatre to 2 other Boston practices, both of whom have become Elatre clients.