Dentist reputation management in 2026 comes down to asking consistently, replying to everything, and knowing where the legal line sits on how you ask. That last part is new and most practices have not caught up: a federal rule covering reviews took effect in October 2024, and it names several tactics that dental marketing companies still sell. The line is not where most people assume, and the part everyone gets wrong is the one we will get to at the end.
Two notes before we start. Google’s local ranking guidance comes from Google. The rule material comes from the Federal Trade Commission’s own guidance. We are not lawyers and none of this is legal advice. Take anything specific to your practice to your own counsel.
Why this changed
The FTC’s final rule on consumer reviews and testimonials took effect on 21 October 2024. It bans fake and false reviews, and it lets the Commission seek civil penalties against knowing violators.
That last clause is what makes it different from guidance. It is a rule with a number attached to breaking it.
For a dental practice the relevant question is not whether you are buying fake reviews, because almost nobody reading this is. It is whether the review programme the marketing company you hired set up quietly does something the rule now names.
Where the line really sits
Incentives tied to sentiment. The FTC’s guidance states a business could be liable under Section 465.4 for providing “compensation or other incentives conditioned on the writing or creation of consumer reviews expressing a particular sentiment.”
Read that against what practices run in the real world. Leave us a five-star review and get $25 off your next cleaning is precisely that shape. So is a whitening giveaway for patients who “share their five-star experience,” and so is the front-desk script that offers a small credit to anyone willing to post something nice before they leave. The rule covers negative sentiment too, so paying someone to leave a bad review for a competitor falls under the same provision.
There is a second consequence people miss. The FTC notes that if a business gives incentives for reviews, those reviews are then also considered consumer testimonials under the rule. Incentivising does not just risk one provision, it moves the reviews into a category carrying more obligations.
Insider reviews. The rule’s disclosure requirements cover certain situations involving company insiders, and it addresses reviews given by officers or managers. Most small practices have a handful of reviews from staff, spouses, or the practice manager’s sister, none disclosed. Worth an honest audit of your own profile.
Suppression. Hiding or burying negative reviews is its own prohibition, separate from anything about faking positives. The rule also addresses a business misrepresenting that a website or entity it controls provides independent reviews, which is worth knowing if anyone has offered to build you a “patient review portal” that sits on your own domain and quietly decides what gets published.
The part of your profile that carries the reviews
Reviews do not sit in isolation, and a practice that gets the review habit right while neglecting the profile underneath is leaving the ranking benefit on the table.
Google is specific about what it weighs. Local results are ranked on relevance, distance and prominence, and the categories you select affect your local ranking, with the guidance telling you to choose a specific primary category rather than a general one. A practice listed as “Dentist” competes differently from one listed as “Cosmetic dentist” or “Pediatric dentist”, and most practices set this once at the beginning and never revisit it.
Hours are the other one nobody checks. If a patient drives to a locked door because your holiday hours were wrong, you have generated the exact review this entire article is about, and you did it to yourself.
So before running any review programme, spend an hour on the profile it feeds: the most specific primary category that is true, secondary categories only where they are also true, real hours including holidays, and photographs taken this year rather than at fit-out.
The part everyone gets wrong
Ask a reputation vendor about review gating, the survey that asks patients how they feel and quietly routes the happy ones to Google, and you will get one of two confident answers. Either it is standard practice and everyone does it, or it is illegal now.
Both are wrong, and the FTC answers the question itself:
Can my business ask for reviews only from customers whom we think are happy with our services? The rule does not contain a specific prohibition against such conduct. But this practice could violate the FTC Act.
That is the real answer. Not banned by this rule. Potentially a problem under the broader Act, and the guidance points to the Endorsement Guides for why.
We are flagging it rather than resolving it, because resolving it is a lawyer’s job and anyone giving you a clean yes or no on a sales call has not read the guidance. What we would say is that the practices with the strongest review bases we see are not gating anyway. They ask everyone, and their rating is a real number that survives scrutiny.
One reassurance, since vendor marketing tends to overstate the threat. The FTC states plainly that the rule “does not provide a private right of action.” A competitor cannot sue you under it. Enforcement comes from the FTC.
What to do instead
The compliant version is also the one that works better, which is not always true but is here.
- Ask everyone, every time, at the same moment. After a completed treatment, in person, then the link by message. No survey in front of it, no filter. About 2 minutes per patient.
- Strip incentives out of the ask entirely. No discount, no raffle, no entry. This removes the whole Section 465.4 question from your practice. One conversation with your team.
- Audit what is already there. Look for reviews from staff, family, or anyone connected to the practice. About 30 minutes.
- Reply to everything within a couple of days, especially the bad ones. Short, warm, no clinical detail, move it offline. About 10 minutes a week.
- Make sure the profile behind the reviews is right. Google says businesses with complete and accurate information are more likely to show up, and that more reviews and positive ratings can improve local ranking. About 1 hour once.
So what really works?
Consistency, and it is boring.
The practices with reputations that hold up are not running clever programmes. They ask every patient after every completed case, they never pay for it, and somebody replies to everything within a couple of days. That is the entire system. It takes a couple of minutes a day and no budget.
What it buys you is a rating that is truly yours. Nobody has to check it, no vendor has to defend it, and no rule change makes it a liability. When the tactics get regulated again, and they will, you will not have to do anything.
The practices that bought a clever programme are the ones re-reading their contracts this year.
Ask everyone. Pay nobody. Reply to all of it.