By this point you have done the hard part. Conversions are tracked, the keywords are researched, the ad groups are tight, the bids are worked out and the ads are written. It would be easy to click through the last few screens and hit publish.
Don't. A new Google Ads campaign arrives with a set of settings already chosen for you, and several of them quietly undo the work of the last eight chapters. They send your ads to websites you never picked, show them to people who will never visit your office, loosen your exact match keywords and even rewrite your ads. None of it is hidden, exactly. It is just pre-checked, and most practices never look.
This chapter goes through the settings one at a time, for the first campaign you launch: the Isolation campaign (our name for the exact match campaign with manual bidding from Chapter 6). Most of the same choices apply to every campaign you build after it. Google moves its settings around often, so the screens may look different by the time you read this. What each setting does, and why it matters, changes far less.
Google Search Only, Until You Have a Reason for More
The first setting that matters is which networks your ads can show on.
Search partners. Google includes search partners by default when you create a Search campaign. These are other websites that show Google search ads, outside Google's own search results. Some of that traffic is fine. In our experience, some of it is low quality, and occasionally it includes clicks that were never made by a real person looking for a dentist. For a new account that needs clean conversions to learn from, that is a risk with no upside. Uncheck it at launch.
That does not have to be permanent. Once the campaign has a few months of real conversions, you can switch search partners on and compare. Google Ads lets you break down your results by network, so you can see exactly what the partner traffic produced. If it brings in real patients at a good cost, keep it. If not, turn it back off.
The Display Network. Uncheck it. Display ads are banner and image ads that follow people around the web, and they belong in their own campaign much later in the rollout, once Google has learned what a new patient looks like. Mixing them into a search campaign muddies everything: the budget, the results and the lessons. Chapter 11 covers where display fits today.
Target Where Your Patients Live, Not Where Google Thinks They Might
Next, locations. Set the area your patients will realistically travel from: a radius around the office, or the cities and ZIP codes you serve. A practice in a dense city might draw from a few miles. A practice in a smaller town might draw from much farther.
Then open the location options underneath, which are easy to miss. Google offers two choices:
- Presence or interest: people in your area, plus people elsewhere who have shown interest in it.
- Presence: only people who are in, or regularly in, your area.
Google recommends "Presence or interest" as a best practice on Search, and for many businesses it makes sense. A hotel wants people planning a trip. But Google also says Presence is the right choice when you want to reach only people in your locations, and that describes a dental practice exactly. A patient has to physically come to your office. Someone three states away who has searched for your city is not going to book a cleaning. For a dental practice, we use Presence.
Languages: English Ads Can Still Need Spanish Settings
Language targeting is less obvious than it sounds. Google decides which language someone understands using signals like the language of their search and the language settings on their device and account. So a patient whose phone is set to Spanish may never see your ads if you target English only, even if they search in English.
If your practice is in a market with many Spanish speakers, like Phoenix, add Spanish to the campaign's languages even if your ads are in English. Do the same for any other language common among your patients. Then watch the results, and consider ads written in that language if the volume is there and your team can serve those patients.
AI Max Is On by Default. Turn It Off in Isolation.
This is the setting that matters most in 2026, and the one most practices will never notice.
Google now says plainly that "new Search campaigns have the AI Max feature turned on by default." AI Max bundles three kinds of automation together:
- Search term matching, which lets Google show your ads on searches well beyond your keywords.
- Text customization, which lets Google write and change your headlines and descriptions using your website and landing pages. This is the old "automatically created assets" setting under a new name.
- Final URL expansion, which lets Google send people to a different page on your website than the one you chose.
Each of those undoes something the Isolation campaign exists to protect. Exact match keeps your ads on the searches you chose; search term matching loosens that. Chapter 8 built ads from your website and your research; text customization rewrites them. Each ad group sends people to the page built for that search; final URL expansion can send them somewhere else. And Google itself notes that AI Max's search term matching "will not work with manual CPC bidding," which is exactly how an Isolation campaign is bid.
So in the Isolation campaign, open the AI Max settings and switch them off. Google is also folding older settings into AI Max this year. It says campaigns using automatically created assets or campaign-level broad match will be upgraded into AI Max starting in September 2026, and new Dynamic Search Ads campaigns can no longer be created. Whatever the screen calls it when you build your campaign, the rule is the same: nothing in the Isolation campaign should be matching, writing or choosing pages on its own.
AI Max does have a place, at the very end of the rollout, once the account has plenty of conversion history. Chapter 13 covers when it earns one.
Bidding, Budget and Goals Were Decided Earlier. Enter Them on Purpose.
A few settings simply carry out decisions you have already made:
- Bidding. Manual CPC for the Isolation campaign. When the Exploration campaign launches later, Maximize Conversions with a target CPA. Chapter 7 covers both.
- Budget. The daily budget comes from the monthly figure you worked out in Chapter 3. As Chapter 7 describes, we often start with a very low budget for the first day or so, just long enough to read Google's bid estimates, then set the real budget and bids.
- Conversion goals. Use the account-level goals you set up in Chapter 1, so the campaign counts the new-patient calls and bookings you decided matter.
- New customers only. Google offers a setting to bid only, or more, for new customers. Leave it unchecked at launch.
- Campaign objective. Google asks you to pick a goal when you create the campaign. We build without its guidance, so that every setting is chosen deliberately rather than filled in from a template.
Let Google Show the Ads That Work Best
Under ad rotation, choose "Optimize: Prefer best performing ads." Your responsive search ads already give Google up to 15 headlines and 4 descriptions to test, and this setting lets it favor the combinations patients respond to. There was a time when rotating ads evenly made sense for testing. With today's ad format, optimizing is the better default.
Demographics Are a Scalpel, Not a Starting Point
Search campaigns let you narrow by age, gender and, in the US, household income. For most dental practices, the right move at launch is to leave these alone. Google also keeps an "Unknown" group for people it cannot classify, and it is on by default. Leave it on, or you may cut out a large share of real patients.
There are exceptions, and they depend entirely on the practice:
- Income. A fee-for-service practice focused on implants or cosmetic work may choose to exclude the lower household income ranges. A practice that accepts Medicaid, or serves families on a budget, should not.
- Age. Age exclusions rarely make sense in dentistry. Parents search for their children's dentist, and adult children often search for their parents'. The person searching is often not the patient.
If you do narrow by demographics, do it deliberately, and let the demographic reports confirm it before you go further. We do not act on a demographic group until it has at least 200 clicks and 5 conversions behind it. Below that, the differences you see are mostly noise, and for a single practice some groups will stay below that line for months.
Your Practice's Name Gets Its Own Campaign
Google offers brand exclusions, which keep a campaign from showing on searches for particular brand names. We rarely use them. Instead, as covered in Chapter 6, the practice name and the dentists' names get their own brand campaign. That keeps those cheap, high-intent searches in one place, protects your top spot on your own name, and keeps them from flattering the results of your other campaigns.
Two Account Settings to Confirm Before You Launch
Two settings live at the account level rather than in the campaign:
- Auto-tagging. This adds a click identifier, called a GCLID, to every ad click, which is how Google Ads and Google Analytics connect a click to what happened after it. Google says it is "on by default for new accounts," but check. An account that was set up years ago, or by someone else, may have it off.
- Call reporting. This lets Google report on calls from your ads, which Chapter 1's call tracking depends on. Make sure it is on.
Google Already Filters Most Click Fraud
Many practice owners worry that competitors or bots will click their ads and drain the budget. Google has protections for this. In its words, "You won't be charged for invalid clicks or impressions," and if it detects invalid clicks after you have been billed, "you receive a credit on your next invoice where appropriate and possible."
You can also exclude specific IP addresses in the campaign settings. That is worth doing only if you see a real pattern, such as repeated clicks from one location with no calls or bookings. It is not something to set up at launch.
The Launch Checklist, on One Page
Here is every setting from this chapter in one place, with what Google chooses by default and what a dental Isolation campaign should use instead.
Go through it before you launch, and again whenever you create a new campaign, because every new campaign starts from Google's defaults, not yours.
Next, the Campaign Google Wants You to Start With
With the settings in place, your search campaigns are ready to launch and learn. The next step in the rollout comes months later, once they are producing steady conversions: Performance Max, the campaign type Google recommends most and dental accounts most often launch too early.
That is Chapter 10, Performance Max.
If you would rather have the build checked before anything goes live, we go through every one of these settings on every dental account we set up. Our Google Ads management starts with a campaign built on your choices, not Google's defaults.
