The bottom line
Nashville Aesthetic runs on brand, not ad spend. The money is pointed the wrong way.
Why it matters90% of revenue comes from people who already know Dr. Wells (organic and direct). Yet 63 cents of every marketing dollar goes to paid ads that return 6.8% of revenue, and Google, the biggest line, loses money.
1,150
Leads
Jan to Sep 2026
138
Cases closed
12.0% lead to sale
$856K
Case value
won, attributed
$6,204
Avg case
wide spread
63%
Budget in paid
= 6.8% of revenue
0.5x
Google ROAS
loses money
Adjust and test
Google is 49% of budget at 0.5x, buying $1,669 general-dentistry cases. Reduce the budget and rework the bid strategy, the PCCD playbook.
Support the phones
27% of calls go unanswered in the data, some of it nights and weekends. Cover the gap so the leads we already pay for convert.
Invest with discipline
Not a blank check to "organic." Freed budget goes to referral, reactivation, and named fixes, each with a target.
Performance by channel
Organic and direct carry the practice. Paid does not.
Why it mattersOrganic search and direct traffic are 90% of revenue on 64% of the leads. The two paid channels are 32% of leads and 6.8% of revenue.
| Channel | Leads | Booked | Closed | Case value | Book rate | Lead→sale | Avg case | Verdict |
|---|---|---|---|---|---|---|---|---|
| Total | 1,150 | 280 | 138 | $856K | 24.3% | 12.0% | $6,204 |
Where the revenue is
Closed case value by channel, YTD
How well each converts
Lead to closed case, percent
The funnel, month by month
Lead flow is steady. The drop-off is between contact and close, not at the top.
Why it mattersLeads are plentiful; the practice converts 12.0% of them to a case. The leverage is mid-funnel, contacting faster and booking more, not buying more leads.
Cohort funnel by lead-created month, current stage as of the pull. Rows are cumulative: a booked lead also counts as contacted. Two caveats: "Shown" is not a stage in this pipeline, so it is not trackable. And "Contacted" is under-recorded because inbound phone-call opportunities often stay in the intake stage and are never moved to Contacted, which deflates contact rate and inflates the book-rate-of-contacted (January reads 100%). Lead-to-sale and AOV are the clean measures. September closes are still maturing, so its closed, revenue, and AOV changes reflect timing, not performance. Change columns compare September to August and to July: green = up 5% or more, yellow = within 5%, red = down 5% or more. Rate rows show relative change.
Budget & ROI
Google is 49% of the budget and returns 50 cents on the dollar.
Why it mattersMarketing ran $88,462 over 8 months, about $11,058 a month (Wonderist is agency of record). $43,657 of it went to Google, which produced $23,361 in case value at a $1,669 average case: a roughly $20K gross loss before any treatment cost. It is buying small general-dentistry visits, not cosmetic cases.
Budget by channel
Jan to Aug 2026, $88,462 total ($11,058 / mo)
Return on ad spend
Monthly case value / monthly spend (log scale). Breakeven 1.0x.
| Channel | 8-mo spend | 8-mo case value | ROAS | Verdict |
|---|
The correction: organic is not a spend dial
Organic's 31x looks like the answer. It is not. Organic and direct are brand equity earned through reputation and word of mouth. A bigger SEO retainer does not linearly buy more $50K veneer cases. Do not just move Google's budget into "organic."
What to actually do with the freed budget
- Bank most of it until a rebuilt, cosmetic-only Google campaign proves a real cost-per-case.
- Fund fixed-scope work, not retainers: the referral system, database reactivation, and the named website and SEO gaps below, each with a defined deliverable and target.
- Instrument the $14,334 in print and sponsorships (16% of budget). It is completely untracked in GHL. Add unique phone numbers and URLs or cut it.
ROAS is gross and directional. It divides each channel's Jan-to-Aug closed case value by its Jan-to-Aug spend. GHL last-touch attribution over-credits organic and direct, so treat the 31x as an upper bound. The paid-vs-organic gap (0.5x vs 31x) is the durable signal, and the practice's own Eaglesoft reporting agrees (Google is a single-digit share of new patients). Paid Social's 2.9x rests on just 5 closed cases, so it is noise, not proof.
Revenue & ROI by channel, by month
Google never clears breakeven. Paid Social's return is one lucky case.
Why it mattersThis is not a bad month, it is the pattern. Google stays below 1.0x in 7 of 8 months. Paid Social is zero in 4 of 8 months, then a single $28.5K case makes July look like 19x. Organic runs 5x to 69x all year. The paid spend is structurally unprofitable, not unlucky.
Monthly case value by channel
Stacked, Jan to Sep. Organic and direct do the work.
Revenue by channel by month
ROAS by channel by month (case value / spend, the three channels with direct spend)
Read it: green is above 3x, amber is 1x to 3x (roughly breakeven on gross case value), red is below 1x (losing money before any treatment cost). Direct, Referral, and Social have no direct media spend, so they carry no ROAS. The ROAS table runs Jan to Aug because September spend is not yet in the budget file. The revenue table's change columns compare September to August and to July (green = up 5% or more, yellow = within 5%, red = down 5% or more); September closes are still maturing. Gross, last-touch, directional.
Case mix: cosmetic vs general
14 cases produced 72% of the revenue. This is a premium-case business.
Why it mattersThe median closed case is $1,058, but a handful of large veneer, smile-makeover, and full-arch cases carry the year. Marketing should chase $15K-plus cases, not lead volume.
Closed cases by size
138 won cases, Jan to Sep, grouped by value
72%
of revenue from the top 14 cases (largest 10%)
$87,640
largest single case
112
cases under $5K, the low-value tail
The tracking gap to fix
GHL is not tagging service line. 76% of opportunities carry no cosmetic-or-general label because most are inbound phone calls. The one tagged cosmetic funnel, the Facebook "Cosmetic Quiz" inside Paid Social, closes at just 2.5%, and it misleads: the real high-value cosmetic cases come in by phone and land untagged. Add a treatment or service-line field in GHL so cosmetic vs general is trackable. Until then, case value is the reliable proxy.
Two conversion leaks
We are leaking the leads we already pay for.
Why it mattersBefore buying more traffic, plug these. Both are fixable in weeks and both cost real cases at an $8K-plus premium AOV.
The phones
- 27% of inbound calls are missed (PeerLogic, H1 2026).
- New-patient calls book at just 40%. Every miss is a possible cosmetic case lost to a rival.
- Some of the misses are nights and weekends. Confirm the after-hours share first, then cover it with Neurality or other coverage so premium leads are not lost.
The website
- The main cosmetic page 404s (/cosmetic-dentistry-nashville/, confirmed live today).
- Financing partners are not named on key pages, at an $8K-plus average case.
- Verify the smile gallery renders and add review and FAQ schema. Booking already works (Smile Virtual plus Book Online), so that is a strength to lean on, not a gap.
Monthly trend
Lead flow is strong. Case value is lumpy, as premium work always is.
Why it mattersMay and June were the peak (45 cases, $344K). July and August cooled on case value even as lead flow held. September leads were up 15% on August; its closes are still maturing, so read its revenue as timing, not performance.
Leads, closed cases, and case value by month
Bars: lead and closed-case counts (left). Line: monthly case value (right).
Market & competition
Rich market, rising demand, a brand rivals cannot copy, and a clock.
Why it mattersDr. Wells is retiring and no longer taking new patients. The brand equity behind our best channels must transfer to Drs. Weese, Bateman, and King before he exits.
+60%
Veneers demand
US search, 2021 to 2026
$3.95B
Veneers market 2030
from $2.17B in 2021
$257K
Brentwood avg HH income
median home $1.03M
$20-45K
Premium veneer case
market range
Nashville Aesthetic Dentistry
Brentwood · Dr. Dennis Wells
AACD accredited since 1994, inventor of DURAthin no-prep veneers, national destination brand.
Us · Destination brand
Nashville Restorative Dentistry
Franklin
Smile makeovers and porcelain veneers, actively targets Brentwood patients.
Closest rival
Brentwood Aesthetic Dentists
Brentwood · est. 1999
Composite veneers and cosmetic work, established local presence.
Local peer
Nashville Dentistry Co.
Brentwood · Dr. Patel
Cosmetic within a family mix. On full-arch, ClearChoice and Nuvia also bid the market.
Local peer
The plan, next 90 days
Fix the leaks, adjust and test the paid mix, then invest with discipline.
Phase 1Days 0 to 30 · Fix leaks, adjust paid
Convert what we already pay for
1
Reduce Google from ~$5,457 to about $3,000 a month and rework the bid strategy.
Paid media0.5x return, $1,669 average case. Keep high-intent cosmetic and brand-defense terms, the playbook from PCCD and other cosmetic practices. Adjust the paid social strategy toward retargeting and test. Hold the ~$2,500 a month freed.
2
Close the phone gap.
Front deskAdd overflow coverage and a same-day callback SLA for every missed new-patient call. Recovering a few misses a month pays for itself at an $8K case.
3
Tighten lead follow-up to a 5-minute first touch.
MM / GHLRoute each new lead to a named person with a call-plus-text in 5 minutes and a 72-hour, 3-touch cadence.
4
Fix the site basics and add a service-line field in GHL.
Web / OpsRepair the /cosmetic-dentistry-nashville/ 404, name financing partners, verify the gallery, add schema. Tag cosmetic vs general so we can finally measure case mix.
Phase 2Days 30 to 60 · Invest with discipline
Fixed-scope programs, not blank checks
5
Build an engineered referral system.
PracticeReferrals close at 28.6% but are tiny in volume. Add a structured ask at case completion, a VIP card, and a doctor-to-doctor cosmetic track. Process work, near-zero media.
6
Reactivate booked-but-unclosed leads.
MM / GHL142 leads booked year to date and did not close. Run a cosmetic re-engagement sequence (financing, proof, limited consult slots) against the owned database. Near-zero cost.
7
Launch the brand-transfer campaign.
BrandWells is retiring. Build Weese, Bateman, and King as named successors now, through Wells-endorsed content and case features, so Direct and Referral equity carries forward.
8
Fund named SEO gaps with targets.
SEO / ContentNot a bigger retainer. Specific deliverables: rebuild the cosmetic page, add All-on-4 and DURAthin pillar pages, each with a rank and traffic goal.
Phase 3Days 60 to 90 · Scale what proves out
Spend follows evidence
9
Re-scale Google only past a 15% close rate.
Paid mediaGate it. If the cosmetic-only rebuild roughly doubles today's 7.8% close on a dedicated landing page and lifts the $1,669 average case, add budget. If not, keep the money working elsewhere.
10
Own the premium position vs local rivals.
BrandNashville Restorative is targeting Brentwood. Press DURAthin, AACD, and the destination-brand proof to hold the premium lane.
11
Stand up a monthly channel scorecard.
GrowthThis report, monthly: leads, close rate, case value, and spend-to-case by channel, so budget follows performance.
90-day targets
Google budget share
49% → ~30%
$5,457 to ~$3,000 / mo
Google avg case
$1,669 → $8K+
Rebuild to cosmetic intent
Missed-call rate
27% → <10%
Coverage + callback SLA
Google lead-to-sale
7.8% → 15%
Cosmetic-intent rebuild
Bottom line: reduce paid volume that does not close, fix the phones and site so premium leads convert, invest freed budget in referral, reactivation, and named fixes with targets, and transfer the Wells brand before he retires.
Sources & method
- Window: performance runs Jan 1 to Sep 30, 2026 (YTD). Budget and ROAS run Jan 1 to Aug 31, matched to the budget file; September spend is not yet in it.
- Channel data: live GHL opportunities pull on Oct 1, 2026, 1,150 records. Channel is the GHL source, normalized. Revenue counts won cases only. September closes are still maturing.
- ROAS: each channel's Jan-to-Aug closed case value divided by its Jan-to-Aug spend. Gross booked value, not collected or profit; last-touch attribution over-credits organic and direct.
- Budget: the practice's actual 8-month spend (Wonderist agency of record), $88,462 total: Google $43,657 (49%), print and sponsorships $14,334 (16%), SEO and influencer video $13,821 (16%), Paid Social $11,754 (13%), social content $2,500, reputation and funnels $2,396.
- Case mix: GHL does not reliably tag service line (76% untagged), so case value is used as the cosmetic-vs-general proxy. Fixing this is a plan item.
- Website: the /cosmetic-dentistry-nashville/ 404 and the working online booking were both confirmed live on Sep 30, 2026. Earlier third-party audit grades were not carried forward unverified.
- Print and sponsorships ($14,334, 16% of budget: Brentwood Lifestyle, Nashville Lifestyle, sponsorships) are offline and not attributable in GHL, so their return is unmeasured.
- Phones, market, competition: PeerLogic phone report (H1 2026) and the Wonderist marketing brief. Eaglesoft production data is directional.