By Angela Weber and Ben Burris

Almost all orthodontists think they have an 80-90 percent conversion rate. And for some that may be true depending on how you measure it and at what point in the game measuring starts. Is conversion rate measured from the first impression, from the first visit to the website, from the first contact with the office, from the new patient phone call, from the first time they make a new patient appointment, from the point where they show up for a new patient visit or is conversion rate only measured at the very end where orthodontic treatment is accepted or refused? The answer to this question determines how accurately you are able to measure your results.

Most orthodontists also believe that Direct to Consumer (DTC) marketing is bad and produces “poor quality leads that don’t show up and don’t convert”. The conversations around this topic put more emphasis on conversion rate than the number of starts! While it is true that patients referred to your office by a dentist generally have higher show up and conversion rates than DTC leads, we are not really comparing apples to apples because of the way most orthodontists think about patient flow.  Let’s run some numbers on a theoretical example. Let’s say a dentist refers 100 patients to you, tells them they need braces and tells them you’re the place to go. How many of the 100 actually call your office?

Here’s what we’ve experienced previously

30 Calls

28 Scheduled

23 Kept Appointments

16 Are actually ready for treatment


13 Starts

That’s 81 percent of the patients who are ready to start (the general way orthodontists calculate conversion rate) but it’s only 13 percent of the patients who care enough to visit a dentist, were given a strong referral by a dental professional they trust and had your business card in their hand. So if you’re going to compare DTC marketing to the dental funnel through which orthodontic patients have traditionally flowed then a 13 percent conversion rate is what you need to start with.

Now, in contrast, when you market direct to consumer you are trying to convince a passive observer with no connection to your office and no referral to call your office, show up and buy treatment. Using the same thought process, out of 100 people who see your DTC ad, how many will click on it and follow up with your office?

Here’s what we’ve experienced

7 Leads

6 Calls

4 Scheduled

3 Kept appointments

2 Are actually ready for treatment


1 Start

That’s a 1 percent conversion rate when first contact is a DTC ad with a cold lead (it’s much, much higher when the person seeing the ad knows someone in the practice or when someone refers a friend but that’s not pertinent here). The knee jerk response from orthodontists when we point all this out is “see, by your own admission the way I do it is 13 times more effective than dealing with those low quality leads you get from DTC advertising”. And that’s true except for one thing. How many of your cards will a dentist hand out vs how many people will see your DTC ad? Which is better? 1 percent of 5000 or 26 out of 200?** Also, who controls the referral source – if you’re using DTC then YOU are in charge of your own destiny! As we all know a dentist can change their referral pattern at any time for any reason or no reason at all.

This stuff is not intuitive but it’s pretty obvious once explained. It’s vital that you understand the differences between the two funnels so that you have the proper expectations for each type of referral source. You certainly don’t want to give up on your DTC campaign when you are starting more cases than you ever have before just because the no show rate goes up and/or conversion rate goes down.  It’s no coincidence.  Starts are all that matter. More is better. Rinse, repeat…

**Any dentist that refers patients to you 20 times a month is a very good referral and 2.6 is 13 percent of 20 but feel free to insert any reasonable number here. We recognize that you have more than one dentist referring to you so we figured 10 very solid referrals who give out your card 20 times a month so 13 percent of 200 is 26. Both the number of referrals and the number of dentists referring are very generous in our minds but feel free to adjust and do your own math as you see fit.  

Also, attaining 5000 targeted impressions a month is easily accomplished with DTC advertising and relatively inexpensive. 

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