Patients are reading your reviews. What do they actually look for?

A prospective patient has an unusual problem when choosing an orthodontist: some of the things that matter most are also the things that are hardest to judge in advance.

A parent cannot easily evaluate an orthodontist's treatment planning by looking at a Google profile. An adult considering aligners may have little basis for comparing the clinical judgment of two specialists. Even a polished website reveals relatively little about what it will actually feel like to spend the next 18 months or two years visiting a practice.

So patients look for other signals.

They ask their dentist. They talk to friends and family. They visit practice websites. They search online. And, increasingly, they read what previous patients have written about their experiences.

The American Dental Association says many prospective patients use online reviews when researching healthcare providers. In an ADA Health Policy Institute survey, 88% of responding dentists said they had received online patient reviews.

A separate 2024 U.S. healthcare consumer survey of 1,426 respondents found that 72.7% said they consider online reviews when selecting a healthcare provider. But perhaps the more interesting finding came when respondents were asked what mattered most about the reviews themselves. Nearly half, 47.2%, selected the sentiment expressed in the reviews. Only 27.7% selected the overall star rating.

For an orthodontist, that distinction is worth considering. The number next to the stars may be what a prospective patient notices first. What patients actually say may be what determines whether they trust it.

A 4.8-Star Rating Does Not Tell the Whole Story

Star ratings are useful because they compress hundreds of individual experiences into a number that can be understood almost instantly. A prospective patient can compare several practices in seconds.

But compression also removes information.

Consider two hypothetical orthodontic practices. Both have a 4.8-star rating. The first has accumulated several hundred reviews over many years, including a steady stream from recent patients. Those reviews repeatedly mention clear explanations, a welcoming team, good communication and positive experiences with children. The second practice has 23 reviews, few of them recent, and relatively little detail about the patient experience.

The headline number is identical. The evidence behind it is not.

This helps explain the findings of RepuGen's 2024 Patient Review Survey. When its 1,426 U.S. respondents were asked which aspect of online reviews mattered most when choosing a healthcare provider, 47.19% selected the sentiment expressed in reviews, compared with 27.65% who selected overall star rating. Provider responses accounted for 13.93%, review recency for 8.42%, and total review count for 2.81%.

Those percentages should not be interpreted as an orthodontics-specific benchmark. The survey covered healthcare consumers more broadly. But they provide useful evidence that patients are doing something more sophisticated than simply sorting providers from five stars downward.

They are reading.

What Patients Are Trying to Learn From Other Patients

That behavior makes sense when the decision itself is considered.

Orthodontic treatment can involve a significant financial commitment and a relationship with a practice that lasts for months or years. Parents may be deciding not only whether they trust an orthodontist's recommendation, but whether their child will feel comfortable returning to the office repeatedly. Adult patients may be balancing treatment against work, family obligations, appearance, cost and convenience.

Before scheduling, they may want answers to questions that are difficult to find on a treatment page.

Does the orthodontist take time to explain things? Does the office usually run on schedule? Is the staff friendly when a patient needs to change an appointment? Are financial arrangements explained clearly? Do parents feel involved in their child's care? Does the practice communicate well when treatment does not go exactly as expected?

A practice can answer all of those questions on its own website. But prospective patients understand that a practice is describing itself.

Reviews offer something different: the accumulated experiences of people who have already been there.

That distinction is important. “We take time to explain every treatment option” is a claim made by a practice. A recurring pattern of unrelated patients describing how carefully the orthodontist explained their options is evidence supporting that claim.

Neither is a substitute for clinical quality. Online reviewers generally cannot evaluate the technical quality of orthodontic treatment in a rigorous way. But they can describe the parts of care they experience directly, and those experiences can influence whether the next patient decides to make contact.

Reviews Have Not Replaced Referrals

The growth of online reviews does not mean traditional referrals have stopped mattering. Healthcare remains unusually dependent on personal trust.

In RepuGen's 2024 survey, 60.1% of respondents said recommendations from family and friends were among the factors they considered when selecting a healthcare provider, while 58.1% considered referrals from medical professionals.

Orthodontic-specific research from the American Association of Orthodontists points in the same direction, while also showing that the market is changing.

In the AAO's 2024 Orthodontic Landscape Consumer Study, a dentist's recommendation remained the largest single reason consumers gave for selecting an orthodontist. Twenty-eight percent identified it as their primary selection driver.

Three years earlier, however, the figure had been 43%.

A decline from 43% to 28% does not mean that online reviews account for the missing 15 percentage points. The AAO data does not establish that, and it would be misleading to imply otherwise. What it does suggest is that the path by which patients choose an orthodontist is becoming less dependent on a single traditional source of influence.

In practice, referrals and online research are also unlikely to operate independently.

A dentist may recommend an orthodontist, after which the parent searches the doctor's name. A friend may enthusiastically recommend a practice, but the prospective patient still reads its reviews before calling. Someone may discover an orthodontist through Google and later ask a neighbor whether the practice has a good reputation.

The referral creates confidence. The online reputation can reinforce it, weaken it or occasionally overturn it.

That makes reviews part of a larger decision rather than a replacement for word of mouth.

What Is the Average Rating for an American Orthodontic Practice?

This is an obvious question, and one for which there is a surprising amount of low-quality information online.

Commercial studies regularly publish figures describing the “average” Google rating for dentists, orthodontists or healthcare practices. Some may contain useful information. But the underlying samples can differ considerably: selected clients, specific cities, scraped Google profiles, limited geographic areas or practices that use a particular software platform.

We did not identify an authoritative national ADA or AAO dataset establishing a single average Google rating for U.S. orthodontic practices.

For that reason, this article does not present one.

There is a second reason to be cautious with such an average even if a sufficiently representative dataset becomes available. Reputation is unusually local.

An orthodontist in suburban Atlanta is not competing for a patient against the statistically average orthodontist in the United States. The patient may be comparing four or five realistic options within driving distance. Those practices form the relevant competitive set.

If the national average were 4.7 stars, that would provide interesting industry context. It would tell the practice relatively little about a local market in which the leading competitors all have ratings between 4.8 and 5.0 and hundreds of reviews.

For an individual orthodontist, a more useful question is therefore often not:

How do we compare with the national average?

It is:

What does a prospective patient see when comparing us with the other practices they are genuinely likely to choose?

A Higher Rating Is Not Always a Stronger Reputation

Even locally, the comparison is more complicated than ranking practices by stars.

Suppose one orthodontist has a 4.9 rating from 41 reviews and another has a 4.8 rating from 687.

Which practice has the stronger online reputation?

There is no objectively correct answer.

One prospective patient may prefer the higher score. Another may consider nearly 700 patient reviews stronger evidence than 41. A third may ignore the difference between 4.8 and 4.9 entirely and read the most recent critical reviews from both practices.

The same issue applies to recency. A practice may have an impressive historical rating, but if very few patients have written about it during the past year, the reputation can appear less current than that of a competitor receiving new feedback every week.

Broader U.S. consumer research supports the idea that review behavior is multidimensional. BrightLocal's 2025 Local Consumer Review Survey, conducted with a representative panel of 1,026 U.S. adults, found that consumers pay attention to the substance of reviews and continue to value descriptions of positive experiences. The research also found changing expectations around review recency and volume.

BrightLocal's research covers local businesses generally, not orthodontic or healthcare practices specifically, so it should not be treated as an orthodontic benchmark. It is useful here for a narrower reason: it reinforces the idea that American consumers use several signals when interpreting an online reputation.

A star rating is one of them.

It is not the reputation itself.

Negative Reviews Are More Complicated Than They Appear

No practice wants a one-star review, particularly when the criticism feels unfair. But an occasional negative review is not necessarily evidence of a poor practice, and it does not automatically undermine a strong overall reputation.

Prospective patients can read criticism in context. They can see whether the complaint concerns something relevant to them, whether similar concerns appear repeatedly, and how the criticism fits with hundreds of other patient experiences.

A complaint about waiting 20 minutes on one occasion is different from dozens of recent patients describing persistent scheduling problems. A disagreement about a bill is different from a recurring pattern of patients saying they did not understand their financial responsibility.

In that sense, negative reviews can sometimes make the overall record more informative.

They can also give the practice information it might otherwise miss.

The difficulty for orthodontists is that healthcare providers cannot always participate in the public conversation as freely as other businesses.

An Orthodontist Cannot Respond Like a Restaurant Owner

A restaurant owner responding to a negative review can usually discuss what happened in considerable detail. The owner might explain that the customer arrived after the kitchen closed, describe an attempt to replace a meal, or publicly offer a refund.

A healthcare provider operates under different rules.

Patient privacy matters.

The ADA has specifically warned dental practices about the risk of disclosing protected health information when responding to online reviews. Importantly, the fact that a patient has voluntarily discussed treatment online does not automatically give the practice unrestricted permission to confirm or discuss that patient's care publicly.

In an ADA Health Policy Institute survey, 39% of responding dentists said they had been unable to respond to an online review because of HIPAA regulations. The same survey found that 52% of responding dentists had replied to an online review.

That creates an asymmetry that can be frustrating for healthcare providers. A patient can publish a detailed account of an encounter. The orthodontist may believe that important context is missing or inaccurate, yet providing that context publicly may create a privacy problem.

The safest response is therefore not necessarily the most satisfying one.

A practice should have a review-response process that accounts for HIPAA, applicable state privacy rules and professional obligations. Staff members responsible for public responses should understand that even confirming that a reviewer was a patient can potentially disclose information the practice is obligated to protect.

This is one area where ordinary advice about “engaging with every review” can become inappropriate when applied uncritically to healthcare.

Reviews Can Be More Useful as Operational Data Than as Marketing

There is another reason to pay attention to reviews that has relatively little to do with attracting new patients.

They can reveal patterns inside the practice.

One complaint about a long wait may be an isolated experience. Twenty similar complaints deserve attention. A single patient who found the financial presentation confusing may have misunderstood it. If the same concern appears repeatedly, the problem may be the way the practice communicates fees and payment arrangements.

Positive patterns can be equally informative.

If patients repeatedly mention one treatment coordinator by name, it may be worth understanding what that person does differently. If parents consistently describe how comfortable their children feel in the office, the practice may have created a patient experience that is genuinely distinctive. If adults frequently mention flexible scheduling or clear explanations, those may be strengths the practice has underestimated.

This is where reputation management can become more useful than simply trying to increase a rating.

The ADA encourages practices to collect patient feedback and use it to identify what patients like and dislike about their experience. Formal satisfaction surveys provide one way to do that. Online reviews are less structured and less representative, but they offer another stream of information.

The goal should not be to treat every comment as equally important. Online reviewers are self-selecting, and their experiences may not represent the patient population as a whole.

The value lies in patterns.

Five Stars Should Not Be the Objective

The obvious temptation is to reduce reputation management to a numerical target: get the practice to five stars and keep it there.

That is too narrow.

A perfect rating with very few reviews may provide less information to a prospective patient than a slightly lower rating supported by hundreds of detailed, recent experiences. An impressive review profile cannot indefinitely compensate for poor communication or an inconsistent patient experience. And efforts to manipulate reviews can create ethical, reputational or platform-related problems of their own.

The more durable objective is trust.

Does the practice's public reputation give a prospective patient a fair and current picture of what it is like to receive care there? Are the experiences described by patients broadly consistent with what the practice promises? When criticism occurs, are there recurring themes worth addressing? Is the reputation current enough to reflect the practice as it operates today?

Those are harder questions than asking whether the rating is 4.8 or 4.9.

They are also more useful.

Reputation Sits Earlier in the Patient Journey Than Most Practices Can Measure

There is a final reason online reputation deserves attention from an orthodontic practice: much of its effect is invisible.

When a prospective patient calls the office but does not schedule, the practice can potentially measure that lost opportunity. The call may appear in the phone system. A treatment coordinator may record the inquiry. Management can compare inquiries with appointments and calculate a conversion rate.

Reputation often operates before any of that happens.

A parent searches for an orthodontist, opens three practice profiles and reads the reviews. One practice immediately inspires confidence. Another creates doubt. The parent calls the first one.

The second practice never knows that a potential patient considered it.

There is no missed-call report. No abandoned appointment. No unscheduled lead in the practice-management system.

The opportunity simply never arrives.

That places reputation near the beginning of the patient-acquisition journey:

Referral or discovery → online research → trust → inquiry → exam → treatment decision.

Marketing can increase the number of people who discover a practice. Reviews can influence what some of those people do with that discovery.

And because that decision often occurs before the practice has any direct contact with the patient, it is particularly difficult to measure.

The Better Question Is Not “How Many Stars Do We Have?”

Orthodontists have good reasons to care about their Google rating. It is highly visible, easy for patients to understand and often one of the first things a prospective patient encounters.

But focusing on the number alone misses much of what makes an online reputation valuable.

Patients appear to care about what other patients actually say. They continue to value personal and professional referrals. They may compare review volume and recency. They look for evidence about the parts of the patient experience they cannot evaluate before walking through the door.

And increasingly, those signals exist alongside one another.

A patient may arrive because a dentist recommended the orthodontist, because a friend had a good experience, because the practice appeared prominently in search, because hundreds of patients had written reassuring reviews, or because all of those things reinforced one another.

The most useful question for a practice is therefore not simply:

“Do we have a good rating?”

It is:

“If a prospective patient who knows nothing about us spends five minutes researching our practice, what will they learn — and will they trust what they see?”

For an orthodontist, that may be a much better measure of reputation than the stars alone.

Data and Methodology

This article draws on several datasets because there is no authoritative national database reporting a single online-review benchmark specifically for U.S. orthodontic practices. Dental-specific, healthcare-wide and broader U.S. consumer research are therefore clearly distinguished rather than combined into a purported orthodontic average.

ADA Health Policy Institute: ADA materials report that 88% of responding dentists had received online patient reviews. The ADA has also reported that 52% of responding dentists had replied to an online review and 39% had been unable to respond because of HIPAA regulations.

RepuGen 2024 Patient Review Survey: The survey included 1,426 U.S. respondents across multiple regions, age groups and income levels, with nearly 93.5% reporting that they had visited a healthcare provider during the preceding year. Because the survey covers healthcare consumers broadly, its findings should not be interpreted as orthodontic-specific patient behavior.

AAO 2024 Orthodontic Landscape Consumer Study: This research provides orthodontic-specific evidence about how consumers select practices. The AAO reported that dentist recommendation was the primary selection driver for 28% of consumers in 2024, compared with 43% in 2021. The data does not establish that online reviews account for this decline.

BrightLocal 2025 Local Consumer Review Survey: The research was conducted with a representative panel of 1,026 U.S. adults and covers local businesses generally rather than healthcare or orthodontics specifically. It is used here only as supporting evidence about broader American review behavior.

Important limitation: We did not identify an authoritative national ADA or AAO dataset establishing the average Google star rating or average number of Google reviews for U.S. orthodontic practices. Commercial datasets may provide useful estimates, but differences in sampling, geography and methodology make it inappropriate to present those estimates here as definitive national benchmarks.

Primary and Supporting Sources

American Dental Association — Protect Your Practice's Reputationhttps://www.ada.org/resources/practice/legal-and-regulatory/managing-dental-practice-online-reviews

American Dental Association — Online Reviews: Guidelines for Practice Successhttps://www.ada.org/resources/practice/practice-management/34_socialmedia_onlinereviews

American Dental Association — 5 Best Practices for Responding to Online Reviewshttps://adanews.ada.org/ada-news/2025/march/5-best-practices-for-responding-to-online-reviews/

American Association of Orthodontists — 2024 Orthodontic Landscape Consumer Studyhttps://www2.aaoinfo.org/orthodontic-landscape-consumer-study-examines-patient-marketplace/

RepuGen — 2024 Patient Review Surveyhttps://www.repugen.com/patient-review-survey-2024

BrightLocal — Local Consumer Review Survey 2025https://www.brightlocal.com/research/local-consumer-review-survey-2025/

Last updated

August 2026