Can a Dental Hygienist Give Botox Injections?

I have been a California RDH for 6 years and I am considering a change of career due to some burnout! I would like to know, if I were to get my esthetician's license would I be able to perform Botox treatments under a physicians supervision? I have my LA license and have obviously had extensive head and neck anatomy classes.

Doctor Answers 9


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With an esthetician's license you are certified to provide care under the discretion of a medical professional. With the appropriate training and supervision many medical offices, plastic surgeons etc. will employ the services of a trained employee to provide care in this manner. I would strongly encourage you, however, to seek out a high level of training and an ethical supervisor that has a supreme knowledge of facial anatomy and experience as an injector.

Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Botox in Florida? Physicians, NP's or PA's only

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The laws on who can inject Botox will vary from state to state, but in Florida, only Physicians, NP's or PA's are licensed to inject.  It makes sense that someone with extensive training in facial anatomy and facial procedures inject Botox; results do vary with technique and expertise.  I would recommend seeing a Facial Plastic surgeon, Dermatologist, or Plastic Surgeon for any injectable procedure.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Botox should be injected by MDs only

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Botox is a very powerful medicine. As many people have noted on this board significant complications can occur if Botox is not administered correctly. A doctor’s experience with Botox will help diagnose these conditions and treat them accordingly. A dental hygienist or an aesthetician should not inject Botox. Keep in mind that the best interest of the patient must be foremost.

For more information on Botox or to schedule an iConsult, please visit us online at: 

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Botox should be injected by MD.

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I don't want to squelch your career aspirations.  But I am pretty sure that you doing Botox injections is not legal.  Even if it were, most people would only want an MD.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Estheticians cannot inject Botox in California

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We were a bit confused because you said you were a California RDH, but that you had an "LA" license. Does this mean Louisiana esthetician's license?

Because every state has it's own set of laws we will not comment on anywhere but California. In California, the only persons allowed to inject Botox are medical professionals including: Registered Nurses, Nurse Practitioners, Physician Assistants and Physician (including Doctor of Osteopathy). An esthetician or dental hygienist would not be allowed to inject Botox regardless of training.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Who is qualified to inject Botox

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Botox should only be injected by a board-certified plastic surgeon or dermatologist.  Botox injections might appear easy, but it is the long years of study and intimate knowledge of anatomy that set physicians apart.  I think estheticians provide a crucial role in complimenting plastic surgery, but they should not be practicing it.

Botox injections

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I personally do not think that anyone but a physician should be injecting botox.  I am not sure what the state requirements are for you but in NY I believe it is only a physician, PA or registered nurse - both of these have to be under direct physician supervision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Who would YOU want to inject you?

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The all too familiar practice of non-aesthetic physicians and non-physicians doing cosmetic procedures, even if technically legal, begs the question: What is in the best interest of the PATIENT??? There are so many qualified, extensively trained, board certified physicians performing these procedures, why take chances with lesser qualified and "Weekend Trained" practicioners? Why not stick with what aestheticians are really trained to do, or go to medical school and residency in dermatology or plastic surgery if you want to do the best for the patient.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Laws vary state by state

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Most states are moving towards only allowing ARNPs (nurse practioners), RNs, and PAs to perform cosmetic injections. Also the supervision requirements are getting more strict and in many states require the physician to be on site.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.