Invisalign Leads: What They Cost and How to Turn More Into Starts

Invisalign leads from paid search typically cost somewhere around $70 to $75 each in 2026, but cost per lead is the least useful number in the funnel. What decides whether a clear aligner campaign pays is how many of those leads book an exam, show up, and start treatment, and most of the loss happens after the lead arrives: slow first contact, too few follow-up attempts, and consults that end with "let me think about it" and no further conversation.

This guide is for general dentists and orthodontists in the US who run ads for Invisalign or other clear aligners and want more starts from the leads they already pay for.

At a glance

• Google Search, Dentists and Dental Services category (includes orthodontics): $72.97 cost per lead, $8.00 cost per click, 10.67% conversion rate (WordStream 2026 benchmarks)
• One orthodontic PPC guide puts an Invisalign campaign at $72 per lead and $6.50 per click (agency figure)
• US clear aligner fees: $3,415 to $8,965, national average $5,245 (ADA fee survey data via Pearl, May 2026)
• Practices that actively worked pending patients converted 18.2% of them within 90 days, about 8 points more than practices that did not (Orthodontic Products, 2019)
• Contacting a lead within an hour made firms nearly seven times as likely to qualify it (Harvard Business Review research)

What does an Invisalign lead cost?

Published benchmarks cluster in the $70s per lead for paid search, with wide variation by city, competition and offer. There is no large, independent dataset for Invisalign alone, so the closest broad benchmark is WordStream's 2026 search advertising data for the Dentists and Dental Services category, which includes orthodontics. Agency figures for Invisalign campaigns land in a similar range.

Two things stand out. First, a lead costs roughly 1% to 2% of a typical case fee, so the ad spend is rarely the problem on its own. Second, the agency figures above describe leads, not consults or starts. Some agency blogs also publish cost per consult or cost per start figures, but the ones we checked used assumed conversion rates rather than measured ones, so we have left them out.

Why is cost per start the number to track?

Cost per start tells you what you actually paid to put one patient into aligners, which is the only figure you can compare with your case fee. Cost per lead hides everything that happens between the form fill and the start.

The formula is simple: total marketing spend for the period divided by the number of aligner starts that came from it. To see where the money goes, track the steps in between:

1. Leads in (forms, calls, chats, ad lead forms)
2. Leads reached (a real two-way conversation, not a voicemail)
3. Exams or consults booked
4. Consults kept (the show rate)
5. Starts, same day and later

Here is a worked example using round, made-up numbers, purely to show how the math moves. It is not a benchmark or a forecast for any practice. Say you spend $7,300 and get 100 leads at $73 each. If 50 book a consult, 40 show and 20 start, your cost per start is $365. If the same spend produced 60 bookings, 48 shows and 24 starts, cost per start falls to about $304 without buying a single extra lead. The lever is in steps 2 to 5, not in the ad account.

Where do Invisalign leads leak?

Leads leak at three points: before the exam, at the consult, and in the weeks after a consult that did not end in a start. Orthodontic practice benchmarks give a rough sense of each one.

These figures come mostly from orthodontic practices and include traditional braces as well as aligners, so treat them as a rough frame. General dentists offering Invisalign often have a different mix, with more adult, elective cases where cost and timing drive the decision.

Leak 1: the lead never becomes a conversation

Clear aligner leads often arrive in the evening and on weekends, when people browse on their phones. If the first call comes the next afternoon, many of those people have moved on, booked elsewhere, or simply stopped answering unknown numbers. Harvard Business Review research found that firms contacting a lead within an hour were nearly seven times as likely to qualify it as firms that waited an hour longer, and that 23% of the companies audited never responded at all.

Leak 2: the consult is booked but missed

No-shows on free consults are common because the patient has invested nothing yet. A booked consult with no reminder and no easy way to reschedule is easy to forget.

Leak 3: the consult ends without a decision

Most aligner patients are adults choosing an elective treatment that costs thousands of dollars. Many leave to check their budget, their insurance, financing, or a spouse's opinion. The Orthodontic Products analysis found that practices which actively managed these pending patients converted noticeably more of them within 90 days than practices that let follow-ups pile up, and it recommended a defined 8 to 12 week follow-up protocol.

How fast should you respond to an Invisalign lead?

Respond within minutes, not hours, and use text as well as a call. A short text that arrives while the person is still on their phone gives them an easy way to reply without picking up a call from an unknown number.

A practical first response looks like this:

Hi Jordan, it's Taylor at [practice name]. Thanks for asking about clear aligners. Would a consult this week or next work better for you?

Notice what the message leaves out: no clinical details, no mention of their teeth, no price promises. It confirms who is texting, references what they asked about, and offers one easy next step.

How should you follow up Invisalign leads that go quiet?

Follow up for weeks, not days, and change the reason for each message rather than repeating "just checking in". A simple structure covers most cases:

• Day 0: text within minutes, then call.
• Days 1 to 3: a second text and call at a different time of day.
• Week 1 to 2: answer the most common questions in plain terms, such as how consults work, whether financing is offered, and how long a typical visit takes.
• Weeks 3 to 6: a lighter check-in with a specific offer of times.
• Months 2 to 6: occasional, relevant messages, then move the lead to a long-term list rather than deleting it.

For consults that ended without a start, the same principle applies with a different focus. Ask what is holding the decision up, answer that one thing, and offer a short call with the treatment coordinator. Record the reason in your practice management system or CRM, so the next message builds on the last one. We cover this in more detail for general dentistry in unscheduled treatment follow-up.

Tone matters. Aligner patients are often self-conscious about their smile, so avoid anything that sounds like pressure, countdowns or before-and-after promises. Keep each message short, polite and easy to say no to, and stop as soon as someone asks you to.

What about the Invisalign leads you already have?

Most practices that have run aligner ads for a year or more have hundreds of old leads that never booked or never started. Those people already raised their hand once, and some of them are still thinking about it. Reopening that list costs far less than buying the same number of new leads.

New leads still matter: they bring in fresh demand and grow your list, and ads are how many patients find you in the first place. But new leads have an upfront cost per lead and no certainty of a start, while the people already in your system have been paid for. Their quality is set by the marketing that produced them, so the question is simply whether anyone is still talking to them.

This is the idea behind lead reactivation: re-open the conversation with old leads by two-way text, answer their questions, and book the ones who are ready into consults. For a sense of scale from a different industry, Cloudy2Clear, a UK misted double glazing repair franchise, gave Setterly 6,769 old leads. 4,321 replied, a 64% reply rate, and the campaign booked 673 appointments. That is a UK home improvement result, not a dental one, and it says nothing about what any practice would see. The full case study shows how it ran.

Is it legal to text Invisalign leads?

Texting leads is common in dentistry, but it sits under two sets of rules: HIPAA for patient information and the TCPA plus state laws for marketing messages. This section is general information, not legal advice, so check your own setup with counsel.

• HIPAA. The California Dental Association notes that standard SMS is not inherently HIPAA compliant, that practices should have a business associate agreement (BAA) with messaging vendors that handle protected health information, and that the minimum necessary standard still applies. In practice, keep texts to scheduling and logistics, never clinical details.
• Consent and quiet hours. Federal TCPA rules keep sales calls between 8 a.m. and 9 p.m. in the recipient's local time. Several states are stricter: Florida, Oklahoma, Maryland and Washington end the day at 8 p.m., and Florida and Oklahoma cap sales calls at three per person in 24 hours.
• Opt-outs. Honor stop requests immediately and keep a record.

Our US compliance page explains how Setterly approaches consent, quiet hours and opt-outs. Setterly does not claim to be HIPAA compliant; we agree the setup with each practice, including whether a BAA is needed, and our texts are minimum-necessary with no clinical details.

Where does Setterly fit?

Setterly re-engages the Invisalign and clear aligner leads you already have, the ones that never booked, never showed or never started, using two-way AI text. The AI answers questions in your practice's tone, at any hour, and books consults into your calendar for your treatment coordinator. Setterly is a service for practices, not a job board for appointment setters.

You pay per booked appointment. There is no setup fee and no retainer. CRM integration is optional for a one-off fee. Pay per appointment is not unique to Setterly, and other companies sell new ad-generated appointments this way. The difference is that Setterly works the leads you already own. You can read how it works for practices on our dental page and how the pricing model compares on pay per appointment.

If you want to talk it through, book a 30-minute call and we will look at your lead list with you.