3 September 2026 · 7 min read · Jason Youngjin Koh

What an implant enquiry costs

Implant and full-arch campaigns get switched off on a number that was never the right one. Cost per enquiry is a ratio with the wrong denominator when the case is worth thousands and the decision takes months.

Cost per enquiry tells you almost nothing about a high value treatment campaign. Cost per accepted case tells you everything. A $300 enquiry that produces a five figure case is a far better purchase than a $50 enquiry that produces a check-up, and practices switch off the first kind every month because it looked expensive next to the second.

The confusion is understandable. Most practices only have one benchmark, formed on general dentistry campaigns, and they apply it to a campaign with different economics at every stage. Then they compare the two on the only metric both campaigns report, which happens to be the one metric that does not carry the answer.

The comparison, done properly

Put the same monthly spend behind both and follow it all the way through. The figures below are constructed to show the shape of the argument. They are not benchmarks, and your conversion rates and case values will differ.

On cost per enquiry the implant campaign is six times worse. On cost per accepted case it is nine times worse. On the number that pays wages, it produces more than half again as much revenue from the same spend. Three different rankings from one set of figures, and only the last one describes what happened to the business.

$1,500
Cost per accepted case in the implant example above, against $300 per enquiry. The alarming figure and the useful figure are describing the same campaign. Illustrative working, not an industry benchmark.

The practice that only tracks cost per enquiry sees $300 and $50 and reallocates the budget. It has just moved money from the campaign returning $3.60 per dollar to the one returning $2.34, and it did so using a number it was confident about.

Why the denominator is the whole argument

Cost per enquiry is spend divided by a count of contacts. It is stable, it reports instantly, and it is the same number in a fifty dollar business and a fifty thousand dollar one. That is precisely why it cannot be compared across them.

Two figures decide whether an enquiry cost is reasonable: how many enquiries become cases, and what a case is worth. Neither appears anywhere in the ad platform. Both live in your practice management software and in whatever record your treatment coordinator keeps. If nobody is joining those two systems, cost per enquiry becomes the only number available, which is worse than having no number at all.

The joining does not need software. A spreadsheet with a row per enquiry, the date, the source, whether a consultation was booked, whether it was attended, and what was ultimately accepted will run a high value campaign perfectly well for the first year.

The consideration period is long, and it is not linear

Elective high value dentistry is one of the slowest consumer decisions in local services. Somebody enquiring about implants is weighing cost, time, the state of their finances, other quotes and their own readiness. Weeks and months are normal, and a report run at thirty days will show you a campaign that appears to have failed.

It is also not a steady march toward yes. The enquiry goes quiet for six weeks, then a tax refund arrives, or a competitor's quote comes back higher, or a partner says get it done, and the person calls back from a position you had written off. Practices that measure conversion at a fixed window systematically undercount, and the longer the window they eventually use, the better the campaign looks.

Two consequences. Your follow up has to survive months rather than days, which means a real recall list rather than a salesperson's memory. And your judgement window has to be longer than your reporting instinct, which is the harder of the two because everyone wants an answer in the first month.

These enquiries need a consultation booked, not a reply

The single conversion step that decides the campaign is enquiry to consultation attended. Nothing that happens in the ad account moves the result as much as what happens in the twenty minutes after the enquiry lands.

A form reply with information attached cannot do this job. The person is not deciding between two paragraphs of copy, they are deciding whether to take a serious step with a practice they have not met. What moves them is a person on the phone, quickly, who can answer the practical questions and put a date in the diary. An emailed brochure asks them to make that decision alone, and most people decline to.

• Call, do not email, and call fast. These enquiries are almost always made to more than one practice.
• Have one named person who owns the call, with a named backup. High value enquiries handled by whoever is free are handled by nobody.
• The goal of the first call is a booked consultation with a date, not a quote. A price given over the phone ends the conversation without the information needed to have it properly.
• Confirm the consultation in writing immediately, and remind before it, because the show rate on a consultation booked three weeks ago is not the same as the booking rate.
• Keep a genuine follow up sequence over months, not days, for the enquiries that do not book first time. That is where a large share of the accepted cases in a high value campaign come from.

The detail, with every rule attributed: what clinics can and cannot say in advertising

What you can actually judge, and when

A high value campaign gives you real information early. It just is not information about cost. Judging each window on what it can tell you keeps a good campaign alive long enough to prove itself, and kills a genuinely bad one before it has spent six months of budget.

The useful failure signals are all early and none of them are cost. Enquiries arriving from outside your catchment, or asking about a different treatment, or answering the phone and having no memory of enquiring. Those are targeting and creative problems and you can act on them in week two. A high cost per enquiry in week two is not a signal at all.

The trap, stated plainly

Judging a high value campaign on general dentistry metrics will kill it every time, because it is worse on all of them right up until the only one that matters. Fewer enquiries, higher cost per enquiry, lower enquiry to booking rate, longer time to convert, and a materially larger contribution per patient at the end.

Run them as separate campaigns with separate budgets, separate reporting and separate expectations. Sharing a budget between them is how the fast, cheap, low value campaign quietly consumes the money meant for the slow, expensive, high value one, and how a practice concludes implants do not work online when what actually happened was an accounting decision.

What to do this quarter

1. Work out your average accepted case value from the last twelve months of actual accepted treatment, not from your fee schedule.
2. Measure enquiry to consultation booked, consultation booked to attended, and attended to accepted. Those three multiplied together are your real conversion rate.
3. Set a cost per accepted case ceiling from your case value and margin, then convert it back into a cost per enquiry target so the ad account has something to chase.
4. Separate high value campaigns from general dentistry campaigns in budget and in reporting, and stop comparing them on cost per enquiry.
5. Agree the judgement window in advance, in writing, before the first enquiry arrives. That is the only moment you will make that decision without a number pulling at you.

For how we measure the whole chain, and which steps advertising can actually move, see the four steps from the ad to the chair