Start by asking for verifiable dental-specific results. A competent dental SEO company should show you anonymized case studies with before-and-after organic traffic numbers, local pack rankings for competitive terms like "dentist [city name]", and examples of practices they've ranked in multiple locations. If they won't share metrics or only talk in generalities, walk away. Evaluate their technical knowledge specific to dental practices. They should understand schema markup for medical businesses, Google Business Profile optimization for multi-location practices, citation consistency across dental directories like Healthgrades and Zocdoc, and how to handle review generation without violating platform policies. Ask them to explain how they'd optimize for "emergency dentist near me" versus "cosmetic dentistry" searches—different intent requires different page structures and content strategies. Check whether they produce actual dental content or generic filler. Most dental practices need patient education content that answers real questions: "how much does a root canal cost in [city]", "do wisdom teeth always need removal", "sedation dentistry options". The company should demonstrate they can write (or hire writers who can write) clinically accurate content without needing your team to rewrite everything. At Ottawa SEO, we find dental practices get the best ROI when content addresses local price expectations and specific procedures the practice actually performs. Watch for these red flags: guaranteed #1 rankings (no one can guarantee this), packages that lock you into 12-month contracts with no performance clauses, or agencies that can't explain the difference between local SEO and organic SEO. Dental practices typically need both, but the budget split depends on whether you're in a 50,000-person city or downtown Toronto. Finally, confirm they understand the patient journey. Dental SEO isn't just about rankings—it's about getting booked appointments. Ask how they track conversions, whether they optimize for mobile (most dental searches happen on phones), and if they know how to set up call tracking so you can measure which keywords actually generate patients versus tire-kickers.