Unblocking an orthodontist's own target towns
An orthodontic practice expanded its Google Ads to eight nearby towns, then kept getting the same small number of leads. Our audit found why: its own negative keywords blocked searches in six of those towns, plus the words in its own offer. We removed the blocks in one pass.
- Client
- Orthodontic practice, US
- Industry
- Healthcare, orthodontics
- Year
- 2026
- What we did
- 6 of 8Target towns the account's own negatives had blocked
- 7 monthsHow long the area expansion had been mostly switched off
- 21Self-blocking negative keywords removed in one pass
Source: Google Ads, client account, our audit and change log, Aug–Sep 2026
The challenge
The practice runs braces and aligner treatment from its offices and spends about $1,500 a month on Google search ads. In February 2026 it widened its targeting to eight nearby towns. Leads didn’t follow: from April to June it got about 12 tracked leads a month at $128 each.
What we found
- Negatives that blocked the practice’s own market. The account carried 4,981 negative keywords across three layers against just 52 live keywords. Six of the eight towns added in February were among them, so about three-quarters of the expansion had been switched off for seven months.
- Negatives that blocked its own offer. “Free” was negated although the ads promise a free consultation, and “plans” although the practice offers 0% financing. Everyday words people use for the service, such as “orthodontia”, “smile”, “overbite” and “specialist”, were blocked too.
- Calls that weren’t counted. Every call conversion action had recorded zero in 90 days, even though call reporting was on. Only the web-lead tracker was counting, so bidding learned from part of the picture.
What we did
- Removed 21 self-blocking negatives on 3 September 2026: 8 at campaign level and 13 from the shared list, covering the towns, the offer words and the service vocabulary.
- Kept the useful blocks. Before removing two broad negatives, we checked what they protected. One guarded against a competitor outside the area, so we held both back rather than open that traffic.
- Flagged the call tracking as the next fix, instead of adding a second call asset that would only have duplicated the first.
Where it stands
It’s too early for a verdict. In September, the first month after the fix, the account recorded 12 web leads at $103 each, against the April–June average of 12 a month at $128. But August, before the fix, was already about $100 a lead, so one month can’t show what the fix changed. We’ll update this page with October–December numbers in January 2027.
Related reading: Google Ads for orthodontists · 5 mistakes that waste your ad spend · Call tracking for lead gen