Google Ads Case Study: 57% Lower Cost per Acquisition for Dental Artistry in Bend, Oregon

Ad examples

Google Search ads from the live Dental Artistry account. Auto-scrolls - hover to pause.

The situation

Dental Artistry is an implant, crown, and veneer practice in Bend, Oregon, voted Best Dentist in Bend in 2025. The practice had years of Google Ads history - structure in place, but optimization lagging and tracking gaps after a domain migration. Google ads for dental practices suffer when negative lists grow without audits and silently block viable procedure terms. The account carried an oversized negative keyword list that had grown without discipline, quietly blocking viable search terms and making performance feel inconsistent month to month.

When UNI took over, the first days of the month were the worst of it: cost per conversion was spiking, and ads were being disapproved. The practice wanted responsive media buying leadership plus a system that surfaced waste automatically - especially search terms spending budget with no conversions.

Implants, emergency, and sedation queries were high value - but the bloated negative archive treated too many procedure variants as guilty until proven innocent.

The insight

Local healthcare PPC fails when negatives become a junk drawer. Lists that never get audited protect against past mistakes but starve campaigns of current demand. The fix is not deleting negatives blindly - it is AI-assisted filtering, categorized lists, and alerts that queue terms for brand review instead of silent exclusion. Dental buyers search by procedure and urgency (implants, emergency, sedation). Architecture must match those intents while automation catches drift before it becomes expensive. Human review stays on brand and high-value procedures; machine speed handles obvious junk - that split is what made 53% positive search term gains sustainable, not a one-time cleanup spike.

What we deployed

Account rescue: malware, a rebuilt site, and an unlock The disapprovals had a root cause. Google had flagged malware on the practice website, and ads pointing to a compromised site do not serve. Patching the old site was not enough, so we rebuilt it on a clean install, removed the malware, and then worked the case with Google support until the account was unlocked and ads served again. No optimization matters while the ads cannot run.

Negative keyword list rebuild Audited and restructured the giant negative list - removed conflicts, categorized by intent, and rebuilt lists so campaigns could compete for qualified local search without repeating past waste. 400+ legacy negatives were recategorized or removed in phase 1.

AI-assisted negative filtering Deployed automation to flag and filter negative keyword candidates from search term reports - human review on anything that touches brand or high-value procedures, machine speed on obvious junk. Flagged terms queue within 24 hours of spend threshold breach.

Spend alerts for zero-conversion terms Built alerting for search terms consuming budget within a rolling 30-day window without conversions - listed for monthly review with the brand instead of silent bleed. Alerts fire when any term crosses $50 spend with zero conversions.

Procedure-level campaign mapping Campaigns realigned to implant, emergency, and general dentistry intents with list-level negatives that do not cross-block sister campaigns. Positive term coverage expanded 53% without reopening past waste categories.

Hand-off to a consultation model with Media Pirate Once the account was stable, we moved to a consultation model: Dental Artistry's in-house Media Pirate runs day-to-day buys, and UNI alerting and architecture reviews keep the account measurable and on cadence. Monthly optimization calls review alert queues, not aggregate CPL alone.

Results

In the first month the account produced 141 conversions from 912 clicks on $19.2K spend. Cost per acquisition came down 57%: it spiked in the opening days after takeover, then flattened through the month and settled under $100 - the $136 monthly average is pulled up by the opening spike, not where the account landed.

Positive search terms rose 53% after the negative architecture and alert system went live. Monthly reviews now have a clear queue - terms to scale, terms to negate, terms to test - instead of guessing from aggregate CPL.

Zero-conversion alerts surfaced $5,500+ in recoverable spend, reallocated to terms already converting locally. Media Pirate executes daily; UNI owns the system that keeps waste visible - a durable split that scales better than fully outsourced buying without tooling.

Why it worked

A clean site is part of the ad account Malware on the landing site shut the ads off entirely. Fixing the website and clearing the policy issue came before any bid or keyword change - that order is why the cost curve could settle.

Negatives need governance, not growth A list that only expands eventually blocks revenue. Structured rebuild plus AI filtering keeps protection without suffocation.

Alerts turn optimization into a process Zero-conversion spend surfacing automatically means the brand reviews real dollars at risk - not a spreadsheet pulled once a quarter.

Consultation scales when tooling is embedded Media Pirate in-house plus UNI automation is the durable model - they own execution; we own the system that keeps waste visible.

Procedure intent beats generic dental When campaigns mirror how patients search - implant vs. emergency vs. sedation - positive term volume grows without inviting irrelevant clicks.

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