An orthodontic marketing agency should be judged on one outcome: started cases, by source, at a cost you can defend. Many proposals promise traffic, rankings and "leads." This guide gives you orthodontic-specific questions to ask, explains pricing models and contract terms, covers who should own what, and sets out where a BAA is required.
Few practices search for this directly: "orthodontic marketing agency" and "orthodontist marketing agency" each get about 90 searches a month in the US (Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026). Most practices find agencies through referrals and conference booths, which makes a structured evaluation more important.
What an orthodontic marketing agency should deliver
A general dental agency can run ads. An orthodontic agency should understand how orthodontic cases are actually won:
- Two patient audiences. Separate campaigns, messages and landing pages for parents and for adults, with budgets you can shift between them by season.
- The referral channel. A plan to support relationships with general and pediatric dentists, such as a referring-doctor page and clear communication, that stays within anti-kickback and ethics rules.
- Cost content. Pages that answer "how much are braces" and aligner cost questions honestly.
- Brand and claims rules. Working knowledge of Invisalign trademark use, photo authorization for minors, and the ADA and AAO ethics codes on advertising.
- Local search. A complete Google Business Profile and a review approach that follows Google's policies.
If you are still mapping the channels themselves, our overview of orthodontic ad channels shows what each one costs and does. For a cross-specialty view of the selection process, see choosing a healthcare marketing agency.
Reporting: consults requested, consults held, starts
Ask every agency to show you a sample monthly report before you sign. A useful orthodontic report has three numbers per channel:
| Stage | What it measures | Where the data lives |
|---|---|---|
| Consults requested | Forms, calls and booking clicks | Website analytics and call logs |
| Consults held | Requests that became a visit | Your practice management software |
| Starts | Patients who began treatment | Your practice management software |
The agency usually can't see the last two without your help, and it shouldn't need patient records to report them. A monthly count by source, entered by your team, is enough. What you are looking for is cost per start by channel, split into parent and adult campaigns.
Watch for reports that stop at impressions, clicks or "leads" with no connection to starts. Those are activity numbers. The free marketing audit gives you an independent baseline before the agency's first report arrives: it scores your website, SEO, Google listing, AI visibility, social and ads.
Pricing models and contract terms
We don't quote agency prices here because there is no reliable public source for them, and proposals vary widely. Our guide to agency pricing models covers the general patterns. The common models are:
- Monthly retainer: a fixed fee for a defined scope.
- Percentage of ad spend: the fee scales with your budget, which rewards spending more.
- Setup or onboarding fee: a one-time charge for build and launch.
- Per-lead or per-patient fees: pay for results, with an important ethics catch.
That catch matters in dentistry. The ADA code (opens in a new tab) says a dentist who pays for marketing by sharing a specified portion of fees collected from patients with the marketing vendor is engaged in fee splitting (Advisory Opinion 4.E.1). The AAO's code (opens in a new tab) bars members from giving or receiving rebates or split fees for referring or accepting patients. Where federal program patients are involved, the HHS Office of Inspector General notes that paying for referrals is a crime (opens in a new tab) under the Anti-Kickback Statute. Have counsel review any pay-per-patient proposal.
Contract terms to read closely:
- Term length, auto-renewal and the notice period to cancel.
- What happens to your website, ads and content on exit.
- Whether ad spend is billed by the platform to your card or marked up by the agency.
- Who owns creative, photos and copy produced during the contract.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
Ownership of your website, ad accounts and data
The most expensive agency mistake shows up on the day you leave. Before signing, confirm in writing:
| Asset | Who should own it |
|---|---|
| Domain name | Your practice, registered in your name |
| Website content and design | Your practice, exportable on exit |
| Google Ads and Meta ad accounts | Your practice, with agency access as a user |
| Google Business Profile | Your practice as primary owner |
| Google Analytics and Search Console | Your practice, agency added as a user |
| Patient form submissions and CRM data | Your practice, returned or deleted on exit |
If an agency uses tracking phone numbers it owns, ask whether you can keep them. Patients who saved those numbers will keep calling them.
HIPAA and the business associate agreement
Under HIPAA, a business associate (opens in a new tab) is a person or company that creates, receives, maintains or transmits protected health information (PHI) on a covered entity's behalf, or provides services such as consulting or management that involve PHI. An agency that receives your consult form submissions, call recordings, chat transcripts or CRM records fits that description.
Before sharing PHI with a business associate, your practice needs satisfactory assurances documented in a written contract (opens in a new tab) (45 CFR 164.502(e)), which is the business associate agreement (BAA). Our guide to business associate agreements explains what one should contain.
Three orthodontic-specific checks:
- Consult forms. Who hosts them, where submissions are stored, and whether ad pixels can see them.
- Smile photos and testimonials. Using them in marketing needs a written authorization under 45 CFR 164.508 (opens in a new tab), signed by a parent or guardian for most minors. Ask who collects and stores those forms.
- Retargeting. Ad platforms should never receive patient information. Ask what the agency's pixels collect, and on which pages.
Red flags in orthodontic marketing proposals
- Promised rankings, starts or "page one." No one controls Google's results.
- Reports with no consult or start data.
- The agency owns your domain or ad accounts.
- Undisclosed markups on ad spend.
- Fees tied to a share of patient revenue, which raises fee-splitting concerns.
- Invisalign logos and brand terms in ads with no plan for Align's rules or Google's trademark policy (opens in a new tab).
- Before-and-after galleries built from photos without signed authorizations.
- No BAA despite handling form submissions or call recordings.
- Referral programs that reward dentists with gifts or payments.
The question checklist
Print this list or copy it into your notes for every agency call, and ask each agency the same questions in the same order so the answers are comparable. For general interview questions that apply to any specialty, see our list of agency interview questions.
- Show me a sample report with consults requested, consults held and starts by channel.
- How do you split budgets and messages between parent and adult campaigns?
- How do you support referrals from general and pediatric dentists, and what do you avoid?
- How do you use "Invisalign" and other brand names in ads, on pages and in domains?
- Who owns the domain, website, ad accounts and Business Profile?
- Is ad spend billed directly to my card by Google and Meta?
- Will you sign a BAA, and which of your tools touch patient information?
- How do you collect and store photo authorizations for minors?
- What is the contract term, renewal and notice period?
- What happens to my content and data when I leave?
Agency vs platform: a factual comparison
Some practices replace an agency with software and keep strategy in-house. Others need people on the ground. Here is how Medfy, a platform, compares with a typical full-service agency arrangement:
| Item | Full-service agency | Medfy |
|---|---|---|
| Price | Varies by proposal | $349/month base plan; add-ons $199 Google Ads, $199 Meta ads + AI creatives, $49 HIPAA AI chat |
| Contract | Varies; often a fixed term | Billed monthly, cancel anytime |
| Ad spend | Depends on the agency | Paid directly to Google and Meta, never marked up |
| Website | Varies | Rebuilt and hosted on your own domain, with HIPAA-compliant forms |
| SEO content | Varies | Researched articles every week, drafted from MedlinePlus and PubMed, approved by you or auto-published |
| Reporting | Varies | Calls, forms, bookings and AI-assistant visits by source, plus a weekly brief |
| BAA | Ask | Signed with every practice before patient data flows |
| Events, referral outreach, social posting | Often included | Not offered |
When an agency is the better fit
Choose an agency if you want people to run school and community events, manage a referring-dentist outreach program, post to social media for you, produce video, or handle several locations. Medfy doesn't do those things. Choose a platform if you want the website, SEO, AI visibility, ads and reporting handled with transparent monthly pricing and you'll run relationships and events yourself. See Medfy pricing for the full plan, and our guide on how to grow orthodontic starts for the work that stays in-house. The orthodontic marketing hub covers every channel.
Frequently asked questions
How much does an orthodontic marketing agency cost?
There is no reliable public price list, so compare proposals by model and total cost. Common models are monthly retainers, a percentage of ad spend, setup fees and per-lead fees. Ask whether ad spend is billed directly by Google and Meta or marked up. Be cautious with fees tied to a share of patient revenue, which the ADA code treats as fee splitting.
What should an orthodontic marketing agency report on?
Consults requested, consults held and treatment starts, by channel and split between parent and adult campaigns. Clicks and impressions are useful for diagnosing ads but don't show results. Expect cost per start by channel each month. Your team can supply consult and start counts from practice software, so the agency never needs patient records to report them.
Do I need a BAA with my marketing agency?
Yes, if the agency creates, receives, maintains or transmits patient information for you, such as consult form submissions, call recordings, chat transcripts or CRM records. HIPAA requires written assurances, documented in a business associate agreement, before that data is shared. An agency that only sees aggregate ad metrics may not need one, but confirm which of its tools touch patient data.