In BrightLocal's Local Consumer Review Survey 2026, published in February 2026, 74% of US consumers said they look for reviews written in the last three months, and 47% said they will not use a business with fewer than 20 reviews. For a dental practice, that turns reviews from a trophy you win once into a flow you have to keep running every week.
BrightLocal sells local SEO and review software. It surveyed 1,002 US adults through a SurveyMonkey panel, gives no fieldwork dates on the page, and asked about all local businesses, not dentists. For a healthcare read I use Tebra's 6th annual Patient Perspectives Report, an online survey of 3,964 US adults fielded on June 29, 2025. Tebra sells practice management software, so treat both as vendor research.
Getting reviews is half the job. The other half is replying, and that is the half where dental practices have actually been fined. This guide covers both: a request system your front desk can run, a weekly routine, a monthly target with the math shown, reply templates that never confirm anyone is a patient, and what to do when a review is fake.
One disclosure before we start: review generation is part of what I sell. Everything below is the do-it-yourself version, and it works without me.
Ask every patient the same way: a short mention in the chair, then a text with your direct Google review link the same day, and one reminder. No incentives, no filtering, no staff quotas. Aim for at least one new review a week. Reply to every review within a few days, never confirming the reviewer is a patient.
- Recency beats volume. 74% of consumers look for reviews written in the last three months (BrightLocal, 2026).
- Four stars is the floor. 53% of patients will not consider a provider rated under 4 stars (Tebra, 2025).
- Replies change minds. 70% of respondents in Tebra's 2025 survey said a provider's reply to a negative review improved their opinion.
- Replies are also where practices get fined. HHS imposed a $50,000 civil money penalty on a North Carolina dental practice that disclosed a patient's information in response to a negative online review (HHS, 2022).
- The rules are federal now. The FTC's rule on consumer reviews, in force since October 21, 2024, bans fake reviews, sentiment-conditioned incentives, undisclosed insider reviews and review suppression (FTC).
Why do Google reviews matter so much for a dental practice?
Reviews do two jobs at once: they help decide whether you appear in the map pack, and they decide whether the patient who sees you there calls. Google says it directly: "More reviews and positive ratings can help your business's local ranking." Reviews sit under what Google calls prominence, alongside how many websites link to you (Google Business Profile Help).
I covered the ranking side, including where rating, count and recency land in the expert surveys, in the Google Business Profile guide for dentists. This guide is about the second job: the shortlist.
Patients compare three or four practices on one screen. Stars and review count are the first filter, before your photos, your website or your fees. Tebra's survey is the closest thing we have to healthcare-specific data, and it lines up with BrightLocal's broader numbers. The wider picture of how patients decide is in how patients choose a dentist in 2026.
The bar is also rising. BrightLocal asked the same star rating question in 2025 and 2026, and the share of consumers who will only use a business rated 4.5 stars or higher nearly doubled in one year.
There is a newer reason to care about what reviews say, not only how many there are. Platforms like Google now use AI to summarize reviews above the individual ones, and BrightLocal found 82% of consumers read those summaries. The summary is built from your patients' own words, which is one more reason never to script them. I cover the wider shift in AI search for dentists.
How many new reviews a month should a dental practice aim for?
My rule of thumb is at least one new Google review every week, which works out to about four or five a month. That is not an industry benchmark, because nobody publishes a credible one for dentists. It is what falls out of three consumer expectations in the BrightLocal data.
There is also a reason not to overshoot. Google's Maps content policy treats content showing "unusual volumes or patterns of review contributions" that point to manipulation as rating manipulation. Thirty reviews in one week after two years of silence is exactly that pattern. Steady beats bursty, for patients and for Google.
If you see a lot of patients, you will clear one a week easily, and that is fine as long as the flow stays steady. The rule is a floor, not a ceiling.
What this means for your practice: write "one review a week, minimum" on the front desk board and check it every Friday. Hold it for a quarter and you pass both recency tests; how fast you pass the 20-review test depends on where you start.
Who should ask for reviews, and when?
One named person asks at the end of the visit, and a text with the direct link follows the same day. Everything else is detail. In most practices the ask fails not because patients say no, but because nobody owns it.
Patients are used to being asked. BrightLocal found 78% of consumers were asked to write a review in the last 12 months, and 28% say they will always write one when asked. What they are not used to is a link that takes four taps to find the review box.
Two details matter more than they look. The script says "an honest review", never "a five-star review": asking for a rating or for specific content breaks Google's rules, and the honest version is the one you can defend. And the text goes out the same day, while the visit is fresh and the phone is still in the patient's hand.
A QR code card at the desk is fine as a backup, since Google's own help page suggests printed codes. Just do not stand over anyone while they scan it.
What this means for your practice: the system costs nothing but a named owner and a saved link. If you change one thing this week, give the ask to one person and put it in their checkout routine.
What are the rules on asking for reviews?
Two sets of rules apply, and you follow the stricter one. The FTC's Trade Regulation Rule on the Use of Consumer Reviews and Testimonials, 16 CFR Part 465, has been in force since October 21, 2024 (Federal Register). Google's Maps content policy sits on top of it and is stricter on incentives.
The FTC rule, announced on August 14, 2024, bans fake reviews, incentives "conditioned on the writing of consumer reviews expressing a particular sentiment", undisclosed reviews by officers and managers, and review suppression through "unfounded or groundless legal threats, physical threats, intimidation, or certain false public accusations". It also lets the FTC seek civil penalties against knowing violators.
Google goes further. Its policy on incentivized reviews covers reviews "influenced by a payment, discount, free goods or services, or any other benefit", and its main policy bans incentives in exchange for posting any review. Note the word any. The FTC's guide for marketers allows an incentive that is not tied to sentiment, if it is disclosed. Google does not, so a gift card for an honest review is still a violation on Google.
| Practice | Google Maps policy | FTC rule and guidance | My rule |
|---|---|---|---|
| Ask every patient for an honest review | Allowed, without incentives and without trying to influence the rating | Allowed | Do it, every patient, same script |
| Ask only patients you expect to be happy (review gating) | Not allowed: merchants may not "selectively solicit positive reviews" | Guidance: don't ask only customers you think will be positive | Never. Same ask to everyone |
| Discount, raffle entry or gift card for a review | Not allowed for any review | Banned if tied to sentiment; otherwise must be disclosed | Never, not even a raffle |
| Staff, family or the dentist reviewing the practice | Not allowed: conflict of interest, including current or former employment | Officers and managers may not post undisclosed reviews | Never |
| Staff review quotas, or asking patients to name a team member | Listed as pressure: "a certain number of reviews" and reviews with "specific content" | Not addressed directly | Track asks, not reviews per person |
| Legal threats over a negative review | Review stays unless it breaks policy | Banned when unfounded or groundless | Flag it, or reply once, calmly |
| Showing only good reviews on your website | Not applicable | Banned to imply they are all or most reviews when negatives were suppressed | Embed them as they are, or say you selected them |
What this means for your practice: read your current review process against that table today. If anything in it says "happy patients", "discount" or "quota", rewrite it before the next review comes in.
What does a weekly review routine look like?
About 30 minutes a week, split between the front desk and one manager. The asking happens every day; the reminders, replies and counting happen on fixed days, so they survive a busy week.
Two reply days a week is not arbitrary. BrightLocal found 81% of consumers expect a reply within a week, and 32% want one by the following day. Twice a week keeps every reply inside a few days without anyone living in the review inbox.
The routine is deliberately boring. Review flow stops for one reason more than any other in the practices I work with: the person who did it left, and nobody wrote it down. Print the timeline and tape it inside the front desk drawer.
What this means for your practice: put a name, and a backup name, next to each row of the timeline before Monday.
How do you reply to a review without breaking HIPAA?
Reply to every review, but never confirm that the reviewer is your patient, and never add a detail they did not post. That rules out their treatment, their appointment, their insurance and their bill. A reply that says "we're sorry your crown didn't fit" has just told the internet who your patient is and what you did.
Not replying is not the safe option either. BrightLocal found 89% of consumers expect businesses to respond to reviews, and 42% say they are unlikely to use a business that never replies. Google notifies the reviewer when you reply, so your words are the first thing they hear from you after a bad day (Google Business Profile Help).
The reason for the caution is in the definition. HHS's summary of the HIPAA Privacy Rule describes individually identifiable health information as information that relates to "the provision of health care to the individual" and identifies them. A public reply that confirms a named reviewer received care from you can fall inside that definition, even though the reviewer posted first. Your compliance adviser should confirm how it applies to you; I write marketing, not legal advice.
This is not theoretical. HHS's Office for Civil Rights has taken action against at least three dental practices over replies to online reviews.
Announcing the New Vision Dental settlement on December 14, 2022, OCR Director Melanie Fontes Rainer put it plainly: "Providers cannot disclose protected health information of their patients when responding to negative online reviews. This is a clear NO."
The fines are small next to what comes with them: corrective action plans, policy rewrites and a page on hhs.gov with the practice's name on it, still online years later. In the Elite Dental Associates agreement, OCR also found the practice had not implemented policies and procedures, including for releasing patient information on social media.
Unsafe and safe replies, side by side
- "We checked your chart and your appointment was at 2:15, not 2:45."
- "Your insurance denied the claim, not us."
- "As we explained at your consultation, implants take months to heal."
- "Glad the root canal went well, see you at your crown visit."
- "Thanks for coming in."
- "Thank you for taking the time to write this."
- "We take every concern seriously."
- "We can't discuss anyone's care in a public forum, but our office manager, Dana, would like to hear from you at (301) 555-0142."
- "Kind words about our front desk always make their week."
- "Calm and clear is exactly what we aim for at [Practice]."
Three replies, marked up
Honestly the least stressful dental visit I've had in years. Everyone explained things before doing anything, and the front desk sorted my paperwork in two minutes.
Thank you for taking the time to write this. Calm and clear is exactly what we aim for at [Practice], and kind words about our front desk always make their week. Dana, Office Manager
Waited 40 minutes past my appointment time and nobody told me why. The cleaning itself was fine but I won't be back if this is normal.
Thank you for raising this. Waiting without an explanation is not the standard we hold ourselves to, and we take it seriously. We can't discuss anyone's visit here, but I would like to hear more. Please call me directly at (301) 555-0142. Dana, Office Manager
Charged me for something my insurance was supposed to cover, and the dentist rushed the whole appointment. Very disappointed.
We're sorry you feel that way, J. Our records show your deductible had not been met, and Dr. [Name] spent 45 minutes on your filling, which is longer than average. We explained all of this at checkout. We hope you'll reconsider.
What went wrong in the third reply: it confirms J. L. is a patient, discloses insurance and treatment details, quotes the appointment length from the record, and argues. Every one of those is the pattern in the HHS cases above. The fix is the same three sentences as the second reply: acknowledge, decline to discuss anyone's care, give a name and a number.
Reply templates you can adapt
| Situation | Safe reply | Never say |
|---|---|---|
| Five stars, short or no text | "Thank you for the review. It means a lot to the whole team at [Practice]." | "Thanks for coming in" or "See you at your next cleaning" |
| Five stars, names a team member | "Thank you. We'll make sure the team sees this." | What that person did, or their role in anyone's care |
| Complaint about waiting or the front desk | "Thank you for raising this. It is not the standard we aim for. Please call [Name] at [number] so we can hear more." | "Your appointment was at..." or anything else from the schedule |
| Complaint about cost or insurance | "We understand cost questions matter. We can't discuss anyone's account here, but [Name] can help at [number]." | Balances, deductibles, claims, or what insurance paid |
| Complaint about clinical care | "We take every concern about care seriously. Please contact [Name] at [number] so we can talk privately." | Diagnoses, procedures, "as we explained", or any defense of the treatment |
| Someone you cannot identify | "We aren't able to discuss any individual's visit here. If you'd like to talk, please call [Name] at [number]." | "You were never our patient" or "We have no record of you" |
| Rant or abuse | One calm line, or flag it if it breaks Google's rules | Anything sarcastic, or anything about the person |
The "never our patient" row catches people out. If you deny it for strangers and stay silent for real patients, the difference itself gives the answer away. Use one neutral line for everyone.
What this means for your practice: save these templates where the person who replies can see them, and add one line to your HIPAA policy: public replies never confirm or deny that anyone is a patient.
What should you do about fake or unfair reviews?
Flag it through Google if it breaks Google's rules, reply once and calmly if it does not, and never retaliate. Google's position is blunt: "Google doesn't get involved in conflict between businesses and customers", and only reviews that violate its policies are eligible for removal (Google Business Profile Help).
So "this is unfair" is not a reason Google will act on. A review from someone who was never at the practice, a competitor, a current or former employee, an account posting personal information, or plain abuse can be. Google's conflict of interest rule names former employment and industry competitors specifically.
- In your Business Profile, open Read reviews, choose Report next to the review, pick the reason and send it.
- Track it in Google's Reviews Management Tool. Google says evaluation typically takes several days.
- If the result is "no policy violation", you get a one-time appeal through the same tool.
- While you wait, reply once with the neutral template. Do not mention that you reported it.
- Keep a screenshot and the date in your review log, in case the pattern repeats.
What not to do is just as specific. The FTC rule bans unfounded legal threats, intimidation and false public accusations aimed at getting a review removed, so a lawyer's letter over an honest one-star review is the wrong move. Replying with the patient's history to prove them wrong is the HHS problem from the previous section.
Do not answer a wave of fake negatives with a wave of friendly positives either. A sudden burst is the pattern Google's rating manipulation policy describes, so the cure becomes a second problem.
What this means for your practice: decide now who may flag reviews and who may answer negative ones. In most practices that should be one manager, not whoever is most annoyed that day.
Which review numbers should you track each month?
Five numbers, checked monthly, tell you whether the system is running: new reviews, rating, recency, reply rate and review link clicks. Add asks sent from the front desk log, and you have everything you need.
| KPI | How to measure it | Target (rule of thumb) |
|---|---|---|
| New reviews this month | Count on your Business Profile, sorted by newest | 4 or 5 minimum, steady week to week |
| Average rating | The rating on your profile, recorded on the same day each month | 4.5 or higher, the line 31% of consumers now draw |
| Recency | Days since the newest review, and reviews in the last 90 days | Under 14 days; 13 or more in 90 days |
| Reply rate and reply time | Reviews answered ÷ reviews received; days to reply | 100%, within a few days; negatives within one business day |
| Review link clicks | Clicks on a short link you own that forwards to Google's review link | Rising with asks sent |
| Asks sent | The front desk log | Every completed visit |
Review link clicks are the number most practices cannot see, and the one that separates "patients are not getting the text" from "patients get it and do not finish". If clicks rise and reviews stay flat, look at the review screen itself: Google requires reviewers to be signed in to a Google account, and some patients stop there.
Count clicks with a link you control, either a link shortener that reports clicks or a tracked button on a page of your own site. The tag setup is the same as in my tracking guide for dental practices.
Dr. Randeep Sidhu of Kraja & Sidhu Dental in Silver Spring described the mechanism better than any review count could: "when someone's about to invest a significant amount, they want to know you're reputable." Reviews are where they check.
What this means for your practice: put the six numbers on one line of a monthly sheet, next to your tracked calls and forms. If you want a second pair of eyes on yours, book a free 30 minute call and I will go through them with you.
How do you audit your reviews today?
Run this checklist once now and then every quarter. It takes about 20 minutes, and every unchecked line is a fix that costs nothing.
- You hold owner access to the Business Profile on a practice account, so you can reply and flag.
- The direct review link is saved and the QR code downloaded (Google only generates it on a computer browser).
- One named person owns the ask, with a backup, and the script is written down.
- The script asks for an honest review, never a rating, a keyword or a staff name.
- Every patient gets the same ask: no satisfaction survey that decides who receives the Google link.
- No incentives anywhere: no raffle, no discount, no staff bonus per review.
- No reviews from staff, family or the dentists themselves on the profile.
- At least one new review in the last 14 days, and 13 or more in the last 90.
- Rating at 4.5 or higher, or the cause written down: volume, a real service problem, or both.
- Every review from the last 90 days has a reply, and none confirms the reviewer is a patient.
- Older replies checked for treatment, insurance or appointment details, and edited or deleted where found.
- Your HIPAA policy includes a line on public review replies.
- Reported reviews checked in the Reviews Management Tool, with nothing left pending for weeks.
- Review link clicks are being counted.
What this means for your practice: do the line about older replies first. If an old reply names a procedure or a balance, edit or delete it today; Google lets you do both from the same Read reviews screen.
Frequently asked questions
Can we use review software that sends a satisfaction survey first?
Can we reply to a review that names the dentist and the procedure?
Should we ask for reviews on Yelp and Facebook too?
Is it fine to text patients the review link?
What if a former employee or a competitor leaves a review?
Do review replies help rankings?
References
- BrightLocal, Local Consumer Review Survey 2026 (n=1,002 US adults, published Feb 11, 2026). www.brightlocal.com/research/local-consumer-review-survey/. Accessed 20 October 2026.
- Tebra, 2025 Patient Perspectives Report, 6th annual (n=3,964 US adults, fielded Jun 29, 2025). www.tebra.com/theintake/patient-experience/tips-and-trends…. Accessed 20 October 2026.
- Federal Trade Commission, Federal Trade Commission Announces Final Rule Banning Fake Reviews and Testimonials, press release, Aug 14, 2024. www.ftc.gov/news-events/news/press-releases/2024/08/federa…. Accessed 20 October 2026.
- Federal Register, Trade Regulation Rule on the Use of Consumer Reviews and Testimonials, 89 FR, Aug 22, 2024 (effective Oct 21, 2024). www.govinfo.gov/content/pkg/FR-2024-08-22/html/2024-18519.…. Accessed 20 October 2026.
- eCFR, 16 CFR Part 465, Use of Consumer Reviews and Testimonials (current text). www.ecfr.gov/current/title-16/chapter-I/subchapter-D/part-…. Accessed 20 October 2026.
- Federal Trade Commission, Soliciting and Paying for Online Reviews: A Guide for Marketers, 2022. www.ftc.gov/business-guidance/resources/soliciting-paying-…. Accessed 20 October 2026.
- Google, Maps User Generated Content Policy: Prohibited and restricted content (fake engagement, rating manipulation). support.google.com/contributionpolicy/answer/7400114?hl=en. Accessed 20 October 2026.
- Google, Maps User Contributed Content Policy: Incentivized or biased reviews. support.google.com/contributionpolicy/answer/16597558?hl=e…. Accessed 20 October 2026.
- Google Business Profile Help, Improve your local ranking on Google. support.google.com/business/answer/7091. Accessed 20 October 2026.
- Google Business Profile Help, Create a Google link or QR code to request reviews. support.google.com/business/answer/16816815?hl=en. Accessed 20 October 2026.
- Google Business Profile Help, Tips to get more reviews. support.google.com/business/answer/3474122. Accessed 20 October 2026.
- Google Business Profile Help, Manage customer reviews. support.google.com/business/answer/3474050?hl=en. Accessed 20 October 2026.
- Google Business Profile Help, Report inappropriate reviews on your Business Profile. support.google.com/business/answer/4596773. Accessed 20 October 2026.
- HHS Office for Civil Rights, Dental Practice Pays $10,000 to Settle Social Media Disclosures of Patients' Protected Health Information (Elite Dental Associates), Oct 2, 2019. www.hhs.gov/hipaa/for-professionals/compliance-enforcement…. Accessed 20 October 2026.
- HHS Office for Civil Rights, Elite Dental Associates resolution agreement and corrective action plan, Sept 30, 2019. www.hhs.gov/sites/default/files/elite-dental-ra-cap.pdf. Accessed 20 October 2026.
- HHS Office for Civil Rights, Dr. U. Phillip Igbinadolor, D.M.D. & Associates, P.A. (UPI) HIPAA Enforcement Action, 2022. www.hhs.gov/hipaa/for-professionals/compliance-enforcement…. Accessed 20 October 2026.
- HHS, HHS Civil Rights Office Enters Settlement with Dental Practice Over Disclosures of Patients' Protected Health Information (New Vision Dental), Dec 14, 2022. www.hhs.gov/about/news/2022/12/14/hhs-civil-rights-office-…. Accessed 20 October 2026.
- HHS, Summary of the HIPAA Privacy Rule. www.hhs.gov/hipaa/for-professionals/privacy/laws-regulatio…. Accessed 20 October 2026.
- HHS Office for Civil Rights, HIPAA Resolution Agreements and Civil Money Penalties (index). www.hhs.gov/hipaa/for-professionals/compliance-enforcement…. Accessed 20 October 2026.