Ivanov Orthodontics is a high-end orthodontic practice in North Miami that recently expanded with a new Miami Lakes office. Braces and Invisalign are a one-time, high-ticket decision, which makes paid search unusually competitive and unusually expensive to get wrong.
Google AdsConversion TrackingLocal SearchGeo Strategy2,064 negative keywords90%+ show-up rate
02 / 05
Nearly $19,000 was lost upfront, making the channel cash-negative and fundamentally unsustainable.
03 / 05
Most budget was flowing toward competitor brand terms, insurance-related searches Ivanov Ortho does not accept, and low-intent modifiers.
cheap bracesno cost orthodonticsfree bracescompetitor brandmedicaid orthodontist
Success was counted as a click on the call button, not an actual phone call, and not a call lasting over 60 seconds. Lead quality and real demand were invisible.
Braces are bought once in a lifetime. The upfront ticket is high, competition is fierce, and a previous agency had left crucial steps missing from the cost-per-booking equation.
Prior agency spend
04 / 05
We started with the negative keyword list. Every wasted query became a permanent exclusion: competitor brands, insurance terms, price-shoppers, job seekers.
from 200 2,064 negative keywords to date
We replaced button-click conversions with real outcomes imported from Liine: new patient booked calls and existing patient booked calls, both set as primary actions.
Both locations serve large areas, so we tightened targeting to a 6km radius per office. Tighter geography means shorter drives, and a show-up rate above 90%.
6 kmper location
A booked appointment that never arrives is not a conversion. We optimised the whole account toward attendance, pushing show-up rates above industry standards across both Ivanov Ortho and Urbn Dental.
05 / 05
Previous agencySpend
Our work · May 2025 → Present
Spend
By quarter · Ivanov Orthodontics
New patient leads
Booked appts.
Conversion rate
We took over the account in May 2025. Conversion rate climbed from 36% to a peak of 76%.
A channel that lost $19,000 upfront now books appointments at $236, and books 77% more of them.
Most accounts we audit are measuring clicks instead of patients. We will show you exactly where the money is leaking, in one call.
Tell us about your acquisition engine. We will show you where the gap is.
Keywords worth 42.5 million monthly searches moved from page seven to position one across a 22-month rebuild.
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