Every orthodontic keyword list starts the same way: someone opens Google's free Keyword Planner, types something in, and copies what comes out. The tool is good. What it returns depends almost entirely on what you feed it, and most practices feed it the wrong thing.
Feed it a vague phrase like "braces" and you get a list built for the whole country's curiosity. Feed it the website of a busy multi-specialty dental group that happens to offer braces, and you get a list about cleanings, crowns and emergency extractions with a little orthodontics sprinkled on top. Feed it the sites of orthodontists who actually advertise in your market and you get something close to a ready-made starting list.
This chapter walks through building that list the way we do it, what to throw out before launch, and why the list is never finished. The numbers come from Keyword Planner across the US and from 12 orthodontic advertisers in one example market, Detroit, labeled as such. Your market's list will differ. The method is the same.
Keyword Planner Builds the List From Whatever Website You Hand It. Hand It the Right One.
Start by finding out who's bidding. Make a short roster of the orthodontists paying to show up for "braces near me" and "invisalign" around your office. The cleaner way is the preview tool built into the account, which Google calls Ad Preview and Diagnosis. It shows the results page for any search, location and device, and Google notes that it avoids piling up ad impressions the way a live search would. Whatever you do, don't click a competitor's ad to look at their page. You'd be spending their money for a peek, and their landing page is one direct visit away anyway.
With the rival list in hand, go to Keyword Planner and pick the website starting point instead of typing seed words. Google describes it simply: enter any site and the tool looks for keywords related to the content on it. One orthodontist's home page at a time, with the location narrowed to the metro you serve. Do this for each orthodontist you found advertising.
Then do it once more with your own site. It's the closest thing you'll get to seeing your practice through Google's eyes. If your own site returns a list full of general dentistry or nothing about the treatments you most want to sell, that's a page problem worth fixing before a single ad goes live, because Google reads the same pages when it judges your landing pages.
A Dental Group's Site Returned 73% General Dentistry Ideas. Eight Orthodontists' Sites Returned 89% to 97% Orthodontic Ones.
We ran this on all 12 example practices in Detroit, each seeded with its own site and set to the Detroit market. Together they returned 6,663 unique keyword ideas.
Eight of the eleven orthodontist sites produced lists that were 89% to 97% orthodontic, heavy on braces, aligners, expanders, retainers and suburb-plus-orthodontist phrasings. Three orthodontic sites came back lower, at 47% to 62%, because their pages filled the list with town names, teeth whitening and general-dentist phrases.
Then there was the one dental group in the sample, a multi-specialty practice that also sells braces and runs orthodontic ads. Only 12.1% of the ideas Keyword Planner pulled from its site were orthodontic. 73.1% were general dentistry.
Across all 6,663 ideas, the orthodontic ones cluster in a predictable way. Braces phrasings were the biggest family, about 1,565 ideas, followed by retainers (477), Invisalign (473), cost and price questions (451) and clear aligners (235). Early treatment and Phase 1 phrasings came to about 100, and phrasings that name adults only about 50. That shape is useful: it tells you the braces ad group will carry the most keywords, and that the adult and early-treatment groups will be short lists built mostly from your own judgment rather than the tool's. It also explains why so many ideas came back as children's dentistry: the dental group's site alone contributed nearly 900 of them.
That isn't a criticism of the dental group's site. It does exactly what a general practice site should. It just makes a poor seed for an orthodontic keyword list, and a practice that copies its list will spend the first month bidding on searches for cleanings it doesn't offer.
Mail-Order Aligners, Job Seekers and Bargain Hunters Belong on the Negative List Before Launch.
Every keyword list needs a second list beside it: negative keywords, the words that stop your ads from showing. Google puts it plainly: choosing what not to target is one key to a tightly aimed campaign. In orthodontics, a few groups of searches show up again and again with real volume behind them and almost no chance of becoming an exam.
Mail-order aligner brands. "Smiledirectclub" still draws 27,100 searches a month across the US, even though the company shut down at the end of 2023. "Byte aligners" gets 4,400 and "candid aligners" 1,000. "Diy braces" and "at home braces" each draw 480. People searching a mail-order brand by name are looking for that company, its refund or its replacement, not a local orthodontist.
Job seekers. "Orthodontic assistant" gets 4,400 a month, "orthodontist jobs" 2,400 and "how to become an orthodontist" 2,400. Those are careers, not cases, and every click on them comes out of the same budget as a parent's.
Bargain hunters. "Cheap braces" draws 2,900 and "free invisalign" 210. A practice that genuinely competes on price may want a version of these; most don't, and the word "free" attracts people looking for something no practice gives away.
Competitor practice names. Seeding Keyword Planner with competitors' sites brings their names into the list. Those come out too. Going after another orthodontist's name is its own deliberate move with its own campaign, and most practices never make it.
A note on how negatives behave, because the wrong form blocks too little. Google's default negative type is broad match, which blocks a search only when it contains every word of the negative, in any order. "Orthodontist jobs" as a broad negative stops "orthodontist jobs near me" but not "orthodontic assistant." Add each idea in the form that matches what you actually want to block.
Insurance and Medicaid Searches Are the Practice's Call, Not a Default Negative.
Some lists you'll find online add "insurance" and "Medicaid" as automatic negatives. Don't copy that without thinking.
Nationwide, "orthodontist that accepts medicaid" runs about 3,600 searches a month. In our example market, the only ad at the top of the page for that search came from a general dentist promising Medicaid patients a $99 exam. Some orthodontic practices accept Medicaid for qualifying children and want those families. Others don't take it at all; two of the 12 example sites say so plainly.
Both are legitimate choices. The point is to make the choice on purpose. A practice that takes Medicaid and blocks those searches hands the families to the dentist. A practice that doesn't take it and leaves the searches open pays for calls it can only decline.
Exact Match Launches the Short List of Searches That Name a Treatment and a Place.
What's left after the negatives is the starting list. Each surviving keyword goes into one of Chapter 4's treatment ad groups, which stay small, around half a dozen phrases apiece. Those groups make up Isolation, our label for the opening campaign, where every keyword runs on exact match and a person types in every bid.
Exact match doesn't mean one spelling. Google says ads on an exact match keyword can show for searches with the same meaning or intent, so a near-identical phrasing or a plural is covered without being listed. What exact match won't do is wander into a different idea. That's the point at launch.
Two more pieces belong here. Your practice name and each doctor's name live in a separate brand campaign, so a referral searching you directly never competes with the braces budget. And keep the phrases people actually type, even when Keyword Planner shows nothing for them. The tool reports no data for "orthodontist near me," "braces cost" or "free orthodontic consultation," even entered one by one, yet it shows about 246,000 a month for "near me orthodontist." The tool files the demand somewhere. You still want the words people use.
A $5.19-to-$32.12 Bid Range Tells an Orthodontist the Neighborhood, Not the Address.
Beside every idea, Keyword Planner prints two dollar figures for showing above the free results, a low one and a high one. In our example market, "near me orthodontist" shows $5.19 to $32.12. "Orthodontist invisalign" shows $6.16 to $38.89.
Use those numbers to see which searches are expensive and which aren't. Don't treat them as a quote. In our experience the price you actually pay can land well outside the range, so we read it as a band of roughly 30% either way around what the tool shows. Chapter 3 gave you the ceiling a booked exam can bear. Chapter 7 turns that ceiling and these ranges into real bids.
The Negative List Is Never Finished. Exploration Will Make It Grow Every Day.
The list you launch with is a start. The real negative list gets written later.
When the account has enough booked exams, it adds what we call Exploration: broad match keywords with Google's automated bidding, built to find the searches nobody would have listed. That's where the scale comes from, and it's also where the surprises live. Broad match can show your braces ad for a rival practice's name, for a dental school's clinic, for a question about a mail-order refund. Competitor names in particular show up in far larger numbers than they ever did in Keyword Planner.
That's why Exploration's first month comes with a daily chore: open the list of actual searches that triggered ads and strike the ones that don't belong. After that, weekly. A negative list that hasn't changed in a month isn't finished. It's forgotten.
An orthodontist who would rather have the list built and watched for them can see what our Google Ads management covers.
Next: Google Showed 84 Questions Under 22 Orthodontic Searches. Chapter 6 Decides Which Ones Exact Match Can Hold.
The starting list is built and trimmed. Chapter 4 gave each treatment its own page. Chapter 6 looks at the long tail beyond the list, the questions people type on the way to booking, and how Isolation and Exploration divide the work.
This chapter is part of Google Ads for Orthodontists, our sixteen-chapter guide for orthodontic practices anywhere in the US.
