- Year One case study
- Dental
- Sherwood Park, Alberta
- Apr 1, 2025 to Mar 31, 2026
The Practice That Took a Side
Exceptional quality, made accessible, and what happened next.
Granada Dental refused the trade-off the dental industry treats as settled: that accessible care means compromise, and premium care means exclusion. Premium materials, current-generation technology and a five-year guarantee on one side. An open commitment to CDCP coverage on the other. This is Year One of what that decision produced.
Year One at a glance
- Brand
- Search
- Paid
- Reputation
- Year One: the starting line
A Great Practice That Nobody Could Find
“We had the team, the technology, and the care, but the phone wasn’t ringing the way it should. We knew we were better than what our online presence suggested.”
Owner of Granada Dental, at the start of the engagement with Evolve One Digital
When new ownership took over Granada Dental, they inherited a practice with real clinical excellence and a genuinely caring team, but also a digital footprint that told a different story.
A change in ownership also resets a practice’s brand equity to near zero. The clinical quality carries forward. The community’s familiarity does not. A previous agency engagement had produced little. The practice had 3 keywords in Google’s top 10. Their social channels were dormant. Their Google Business Profile was functional but invisible.
In a market where patients make decisions in seconds based on what they see online, Granada was losing before the conversation even started.
Keywords in Google top 10
New patients per month
Percentile for online reviews
That was Q1 2025. What follows is Year One.
Over 12 months, Evolve One Digital rebuilt Granada’s growth engine from the ground up, coordinating brand identity, paid media, SEO authority and local search dominance into a single compounding system. The result was not incremental improvement. It was a rebuild of the practice’s brand equity, and then a demonstration of what that equity does to the cost of acquiring a patient.
- The outcome
Business growth, plus exponential digital gains
Revenue growth
An additional $182,978 in the final quarter of Year One versus the same quarter the prior year. An average of +$60,993 per month across that quarter.
New patient volume
Average monthly new patients grew from 19 a month to 46.7 a month. Each dot is one new patient.
Google Ads cost per patient action
Against a 2026 industry benchmark of $72.97 per dental lead: 75% below benchmark.
These are business outcomes: the numbers a practice owner sees in their management software, their bank account and their schedule. One note on how we report them: revenue reflects total practice performance across a period in which marketing was the primary variable changed. We report it as correlation with a named cause, not isolated attribution. We would rather draw that line ourselves than have you find it.
Brand builds the moat
Identity work, content strategy and social presence create the top-of-funnel awareness that makes every downstream channel more efficient. Patients who recognize Granada before they search convert faster, cost less and stay longer.
Search captures the intent
SEO authority and local map pack dominance ensure Granada appears at the exact moment a patient decides they need a dentist. Organic and local search compound over time: the authority built in Year One lowers the cost of growth in every year that follows.
Paid closes the gap
Google and Meta advertising capture demand that organic hasn’t yet reached, at a CPA 75% below the 2026 industry benchmark. As brand authority grows, paid efficiency improves. The flywheel accelerates itself.
The outcome is a practice that doesn’t depend on any single channel, because all of them are working together. That is what makes the growth sustainable, not just impressive.
Benchmark source: LocaliQ / WordStream 2026 Google Ads Benchmarks, Dentists and Dental Services category. 13,000+ campaigns, data period April 2025 to March 2026, the same twelve months as this engagement.
- The Evolve Dental Growth Framework
Six outcomes. One engine.
Evolve runs every dental engagement on six outcomes, not six channels and not six budgets. They are six capabilities one engine builds at the same time, at different speeds. The rest of this case study is organised by them.
Establish Visibility
Be the clinic they find firstWhen a patient searches “dentist near me,” the top three results get the calls.
See the resultsValidate Trust
Be the clinic they trust before they callMost patients choose before they ever pick up the phone.
See the resultsOpen the Pipeline
Capture demand the moment it appearsSome patients are searching today. Be there at the point of highest intent.
See the resultsLand the Appointment
Turn interest into booked chairsEvery enquiry that does not become an appointment is revenue leaking from a bucket you already paid to fill.
See the resultsVerify Performance
Know what is working, and make it repeatableGrowth you cannot explain, you cannot repeat.
See the resultsExpand Demand
Be the answer AI recommendsPatients now ask ChatGPT and Google AI Overviews who to trust before they open Maps.
See the resultsThe Brand-Formance Loop™
Underneath these six sits one repeating cycle. Publish enough to learn what resonates, then put paid budget only behind creative the market has already validated. The same dollar builds the brand and books the appointment.
- Produce
- Observe
- Convert
- Amplify
- Prove
- E: Be the clinic they find first
- Local search
Google Business Profile and Maps: owning Sherwood Park discovery
Year-over-year growth in Google Business Profile interactions
+74.1% growth in profile searches year over year. Patients are actively finding and choosing Granada.
Direct phone calls
Website visits
Direction requests
Google Business Profile is the most consequential touchpoint in local dental search. Every Maps result, every “call” button, every direction request flows through it. A patient deciding between two practices in the same neighbourhood will choose the one that shows up first, looks complete and has recent reviews.
Granada started the engagement with a functional but underpowered profile. By month 12, it had become a primary patient acquisition engine. Optimized service descriptions, enhanced photo sets, a regular post cadence, proactive review management and citation building turned the profile from a passive listing into an active conversion tool.
What it means for the business: 4,371 direction requests is 4,371 people who pointed a navigation app at Granada’s front door.
Local SEO grid: who sees Granada in the map 3-pack
Mastering the Google Map 3-Pack: coverage, depth and dominance
Local map pack placement is the most valuable real estate in local service marketing. It captures patients at peak intent, before they visit a website or read a single review.
The “Children’s Dentist” result tells the most important story: a term where Granada essentially didn’t exist at engagement start is now generating top-3 appearances across 5.9 square miles of Sherwood Park. That is not optimization. That is market capture.
42% of local searchers click a result inside the Google 3-pack. Backlinko.
Best dentist near me
Best dentist
Children’s dentist
Invisalign
What it means for the business: map pack placement is the moment a patient stops researching and starts choosing. Granada now appears in that moment across five to seven square miles of Sherwood Park, in categories where it previously did not appear at all.
- E: Be the clinic they find first
- Organic search
SEO: authority, visibility, and a market that now searches for you
Across 12 months, Granada’s organic search presence was rebuilt from the ground up: from 3 keywords in Google’s top 10 to 15, from 302 organic clicks to 1,622, and from a practice patients stumbled upon to one they actively seek out by name.
Growth multiple, Year One versus start
Each bar shows how many times bigger the metric ended the year.
The /meet-the-team page became the second-highest-traffic page on the entire site, with 404 organic clicks and 11,846 impressions, behind only the homepage. Patients research who will be treating them before they book.
Top keyword movers
Positions gained in Google. Each one is a direct revenue opportunity captured from competitors.
Emergency Dentist Sherwood Park
The highest-intent, highest-value category in dental search. A patient searching this term will call the first practice that appears.
Best Dental Implants Sherwood Park
The highest-value elective procedure in dentistry. Top-10 visibility directly impacts high-revenue case volume.
Best Cosmetic Dentist Sherwood Park
High-consideration, high-value patients already committed to investing in their smile.
Best Dentist Sherwood Park
The most competitive local dental term, now a top-3 Maps result across Sherwood Park.
Invisalign Sherwood Park
A term with zero presence at engagement start, now a top-10 ranking driving qualified Invisalign enquiries.
Brand equity is built by appearing credible, consistently.
SEO authority built in Year One lowers the cost of growth in every subsequent year. It is the one marketing investment that gets more valuable the longer it runs. Local SEO delivers $13 in return for every $1 invested (BrightLocal / Industry Research 2025).
- V: Be the clinic they trust before they call
- Social media
Social: from dormant to 197,000+ reached
Granada’s social channels were essentially inactive at engagement start. The first strategic decision was to stop posting for the sake of posting and build a content system anchored in the practice’s genuine identity: the team’s personality, the CDCP commitment, and the specific stories of the doctors and patients.
Social reach
Up from 5,729 (34.5x)
Posts published
Up from 11 (24.5x)
Engagements
Up from 253 (6.1x)
Social link clicks
From near zero to a meaningful traffic driver
Exceptional quality, without the gatekeeping
Premium materials, current-generation technology and a five-year guarantee on dental work. Quality defined as a standard the practice holds itself to, not a price tier it sells into.
Radical accessibility
The public commitment to accepting CDCP coverage was not a promotion. It was a values statement about who the practice is willing to treat.
The practitioner as the brand
Dr. Milan Khangura’s clinical standard and commitment to the community became the visible face of the practice, rather than the practice being presented as a facility.
Each square is one of the 270 posts published in Year One.
of the year’s reach came from 3 posts out of 270.
Nobody can tell you in advance which three posts will carry a year. You find out by publishing enough to find out. The 267 that did not break through were the cost of discovery, and discovery is far cheaper than putting paid budget behind a guess. Volume finds the winners. Observation identifies them. Paid scales them.
CDCP Coverage Post, May 2025
One organic post about Granada’s commitment to accepting CDCP dental coverage reached more people than the entire previous 12 months of social activity combined.
Meet Dr. Milan Khangura, September 2025
The practitioner is the brand. Patients don’t choose a clinic. They choose a person. When they feel they know Dr. Milan before the first appointment, the conversion happens before the phone ever rings.
New Granada Brand Awareness, April 2025
The third-highest performer from the earliest weeks of the engagement shows that the market was ready. Granada just needed to show up consistently.
- V: Reputation
From 61st to 81st percentile, and what the reviews actually say
Review percentile across all Google dental listings. 200 new Google reviews in 12 months, roughly 17 a month, sustained.
Patients name individual team members. Monica appears in 23 reviews. Dr. Milan appears in 21. When patients name your staff in public reviews, they are doing your marketing for you. That is advocacy, and it is the only marketing asset a competitor cannot buy.
Review recency now carries as much weight as review average in local ranking, which makes velocity, not the star rating, the metric to protect.
- O: Capture demand the moment it appears
- Paid advertising
What brand equity does to cost per patient
Total patient conversions
Appointment leads and direct phone calls over 12 months
Cost per patient action
75% below the 2026 industry benchmark of $72.97
Total ad spend
The entire annual investment that produced 788 patient conversion events
What this means for the practice
788 conversions at $18.20 each. At the 2026 industry benchmark of $72.97 per dental lead, those same 788 conversions would have cost approximately $57,500. Granada spent $14,341.
The difference, roughly $43,159 in media that did not need to be spent, is the financial return of brand equity showing up as performance efficiency.
- The part most agencies delete
The first five months cost more. That was the point.
Monthly Google Ads conversions and cost per acquisition, April 2025 to March 2026.
May and July 2025 were not reported. Values are shown as reported in the Year One report.
Why the curve looks like this
April 2025: two conversions, at $138 each. June 2025: six conversions, at $152 each. If Granada had judged this engagement at month three, they would have cancelled it, and they would have been reading the data correctly and drawing the wrong conclusion. A change in ownership resets a practice’s brand equity to near zero. Months one through five were the cost of rebuilding recognition a new owner had not yet had time to earn.
The plateau matters more than the low
By month eight, cost per patient action had settled into a $12 to $15 range and stayed there for six consecutive months, while monthly conversions climbed from 2 to over 100. The budget never changed. What changed was that the market had learned who Granada was. CPA fell approximately 89% from month one. A number that holds for six months is a system. A number that touches a low once is an anecdote.
This curve is not a flaw in the model. It is the model. Brand equity is a fixed cost paid early that lowers a variable cost permanently. Any agency promising month-one efficiency is either harvesting branded search you already own, or about to show you a number that has nothing to do with booked patients.
Cold prospects, below benchmark
Cost per conversion (Google, non-branded keywords) and cost per call (Meta), against the $72.97 dental benchmark.
The cold prospect problem
Branded keywords are easy wins. Non-branded keywords are the real test of cold customer acquisition. “Emergency dentist near me” and “dental implants near me” are searched by patients with no practice preference. Winning those moments at $26 to $50 per conversion, against a $72.97 benchmark, is where paid search stops being a cost and starts being an advantage.
The doctor introduction that converts
The “Meet Dr. Milan” campaign at $25.35 per call is the most instructive number in the paid portfolio, roughly a third of the benchmark. A patient who calls after watching a doctor introduction is not price-shopping. They have already chosen. Total Meta reach over the year: 1.27M impressions and 7,860 link clicks.
Campaign creatives
LocaliQ / WordStream 2026 Google Ads Benchmarks, Dentists and Dental Services. 13,000+ campaigns, April 2025 to March 2026, the same twelve months as this engagement.
- L: Turn interest into booked chairs
- Patient actions
Land the appointment: the patient actions behind Year One
Every enquiry that does not become an appointment is revenue leaking from a bucket you already paid to fill. These are the actions patients took to reach Granada across Google Ads, Google Maps and Meta in Year One.
Google Ads patient actions
644 website appointment leads and 144 direct phone calls
Calls from Google Business Profile
Patients tapping “call” on the Maps listing
Calls from Meta campaigns
Including 147 from the CDCP video and 78 from Meet Dr. Milan
Direction requests
People who pointed a navigation app at the clinic
1,302 phone calls from three channels
Inbound calls in Year One by source, combined from Google Business Profile, Meta and Google Ads.
These are patient actions, not confirmed appointments. Attribution from ad click through to booked appointment is still being built out, and closing that loop is a Year Two priority. We would rather name it here than have you discover it later.
- V: Know what is working, and make it repeatable
- The bottom line
Quantifiable growth. Lasting impact.
Every metric below is a direct output of the Evolve One Digital dental growth framework: a compounding system where brand, search, paid and reputation work as one.
Revenue growth
An additional $182,978 in the final quarter of Year One, an average of +$60,993 per month across that quarter.
New patient volume
Monthly new patients grew from 19 to 46.7. The practice two-and-a-half times its patient intake in twelve months.
Brand search growth
Direct searches for “Granada Dental” grew from 772 to 3,483 annually. Patients now seek the practice by name before they ever see an ad.
Revenue growth is the outcome. New patient volume is the engine. Brand search growth is the proof that the market has changed its mind about who the best dentist in Sherwood Park is.
| METRIC | YEAR ONE RESULT |
|---|---|
| Final-quarter revenue increase (YoY) | +$182,978 (+37.4%) |
| Average monthly revenue increase | +$60,993/month across that quarter |
| New patient monthly volume | 19/mo to 46.7/mo (2.5x) |
| Online impressions | approx. 13K to 1.82M (140x) |
| Organic impressions | approx. 13K to 163,134 (12x) |
| Google Ads CPA | $18.20 vs $72.97 benchmark (75% below) |
| Keywords in Google top 10 | 3 to 15 (+400%) |
| Organic clicks | 302 to 1,622 (+437%) |
| Social reach | 5,729 to 197,633 (34.5x) |
| Review percentile | 61st to 81st |
| AI search referrals | 34 tracked sessions |
- E: Be the answer AI recommends
- AI search visibility
34 tracked sessions from AI assistants, and almost no practice is instrumented to see them
Tracked sessions arriving from AI assistants in Year One
Thirty-four sessions is not a channel yet. It is a signal. Granada is one of the few dental practices in Western Canada with any measured visibility into AI-assistant referral traffic at all, alongside a monitored citation baseline across ChatGPT, Perplexity, Google AI Overviews and Gemini.
We report this as forward positioning and competitive intelligence, not as attributed revenue. Evolve began active AI citation monitoring for Granada using Otterly.ai.
Google AI Overviews: the new front page
AI Overviews now appear on approximately 88% of healthcare queries, up from 72% a year earlier, the highest rate of any industry tracked.
BrightEdge AI Overview prevalence data, Q1 2026.
Ranking beneath the answer is worth less
When an AI Overview appears, organic click-through rate on the results below it falls sharply. Studies place the drop between 34% and 61%. Being cited inside the answer is now worth more than ranking beneath it.
Seer Interactive longitudinal CTR study; Ahrefs 300,000-keyword analysis.
- Strategic impact
Key success factors: why this worked
Not a collection of tactics, but an integrated system where each investment amplified the others.
A position, not a promotion
The engagement began by naming what Granada refuses to accept: that exceptional care and accessible care are two different products. Every campaign was rooted in that position. It is why the CDCP campaign converted at $32.97 per call against a $72.97 benchmark.
Organic before paid
No paid dollar was spent amplifying unvalidated creative. The Brand-Formance Loop™ requires organic content to prove resonance before paid amplification begins.
Local authority as infrastructure
GBP optimization, map pack ranking and citation building are the infrastructure that makes every other investment more efficient. Every local authority investment has a multiplier effect across the funnel.
Performance proof as content
Every result was turned into content. Reviews create credibility. Educational content from the clinical team builds authority. Results compound when they become the content that attracts the next patient.
Brand content 1
Built social reach and audience familiarity
Reviews and trust 5
Better rankings drove more reviews, building trust for the next patient’s conversion
2 Paid conversion
Familiar audiences converted at lower CPA
3 SEO content
Lower CPA freed budget for organic authority building
4 GBP rankings
Organic authority improved Google Maps positions
Each channel fed the others. That is a brandformance flywheel.
- Looking forward
What this took, and what it has not fixed yet
Case studies that read as effortless are usually the least useful ones.
What it required
A clinical team willing to be on camera repeatedly across twelve months. A practice willing to state a position publicly and accept losing the people who disagreed with it. Front desk participation in review capture, because 200 reviews do not appear on their own. And patience through five months where the numbers looked worse before they looked better.
What it has not fixed yet
Every number here is net-new patient acquisition. Recall, reactivation and referral, the highest-margin demand any practice has, are untouched. Attribution from ad click through to booked appointment is still being built out. These are the Year Two priorities, and we would rather name them here than have you discover them later.
A partner who only shows you the parts that worked is showing you a sales document, not a case study.
Three questions to ask about your own practice
How many keywords does your practice rank for in Google’s top 10?
Granada started at 3. Most practices we audit are in a similar position, often without knowing it.
What percentage of your local area sees your practice in the Google Map 3-pack when searching “dentist near me”?
Granada started at 7.4% coverage. The average practice we onboard is below 15%.
What is your current cost per new patient across all paid channels?
The 2026 benchmark is $72.97 per dental lead. Granada’s blended cost settled into a $12 to $15 range by month eight. Their full-year figure was $18.20.
If you do not know the answers to these three questions, that is the discovery gap. And it is costing your practice patients every single day.
- The next step
The Discovery Gap Audit
You just answered three questions. Here is what happens if you did not like your answers. One week. Fixed scope. You keep everything, whether we work together or not.
Your map pack coverage grid
The actual percentage of your city that sees you in the top three for “dentist near me,” mapped. Granada started at 7.4%.
Your keyword position audit
How many top-ten rankings you hold today, and which competitor holds the ones you do not. Granada started at three.
Your true blended cost per new patient
Across every channel, including the ones you are not currently counting.
Your brand advocacy score
Your practice scored across eight brand principles using our Advocacy Audit, with the two to fix first identified.
Your AI visibility baseline
Whether ChatGPT, Perplexity and Google AI Overviews currently mention your practice when a local patient asks. Most practices have never checked.
Your 90-day priority sequence
What to fix, in what order, whether we do it or you do.
No obligation and no retainer conversation unless you start one. If the audit shows you are already ahead of your market, we will tell you that, and you will have lost an hour.
Data sources, and what we can and cannot attribute
All data sourced from practice management reporting, Google Ads, Meta Ads Manager, Google Business Profile, Google Analytics 4 and Google Search Console for April 1, 2025 to March 31, 2026, referred to throughout as Year One.
Practice management reporting
Revenue, new patient volume and appointment data sourced directly from Granada Dental’s practice management system.
Google platforms
Google Ads, Google Business Profile, Google Analytics 4 and Google Search Console for the full 12-month period.
Meta Ads Manager and AI monitoring
Facebook and Instagram campaign data including reach, impressions, link clicks and call conversions. AI citation monitoring via Otterly.ai; session data from GA4.
What we do not claim
Revenue figures reflect total practice performance across a period in which marketing was the primary variable changed. We report correlation with a named cause, not isolated attribution. AI assistant figures are tracked sessions and monitored citations, not attributed patients. Where a number is a benchmark rather than a measurement, we say so and cite it.
Sources: Backlinko (map pack click share); BrightLocal 2025 (local SEO return); LocaliQ / WordStream 2026 (dental cost per lead); BrightEdge Q1 2026 (AI Overview prevalence); Seer Interactive and Ahrefs (AI Overview click-through impact).