Why Should Dental Hygienists Not Be Allowed to Perform Therapeutic Botox?

Laws are created state by state as to who can inject medicines. One state may allow non licensed individuals and others may only allow MDs PAs and NP / RNs.  Same with the operation of lasers. It is important to check with each state as to the laws and have them explain their rules.

Hi RDH.  The laws in the state of California are set up so that only certain medical licensees are allowed to provide Botox.  The reason for this is patient safety.  Botox is a very safe drug, but just like any drug, can be dangerous in the wrong hands.  Only RNs, NPs, PAs and MDs are allowed to inject the drug and if an NP, PA and RN is not directly supervised, they can only inject when a standardized procedure is in place.  

We hear from estheticians almost every day that want to offer laser procedures and cannot.  The reason again is patient safety.  The livelihood of the persons that hold the MD, PA, NP and RN degree is dependent on maintaining those licenses.  And they are generally harder to acquire than an esthetician's license or a dental hygienists license.  Because these professionals value their licenses very highly, they are generally expected to have more training and to continually update that training, which ultimately lowers the risk that a consumer will have an adverse event.  

You must also realize that Botox is a prescription product and that dental hygienists are not allowed to write prescriptions.  So, while many patients trivialize Botox as a medication, it still is.  Bottom line is that states have to draw the line in the sand somewhere and it has been drawn in California at the RN level.

If you feel that your specialty should be able to provide Botox, then you should speak with your state licensing agency about that fact. 

I think the issue here is professional envy and arrogance.  Sure, as a dental hygienist you are highly trained for the tasks you perform.  You might be a very capable individual and perhaps in other circumstances perhaps you might have gone to medical or nursing school.  However, you choose a career in dentistry as a dental hygienist.  In California, only a handful of general dentists are qualified to inject BOTOX cosmetically.  So why do you think that you should be injecting the public with a service that dentists are not permitted to practice?

Please remember that being qualified to inject local anesthetic under the supervision of a dentist in no way qualifies you to safely inject BOTOX for the public.  I personally believe that the public is best served when highly qualified individuals offer services.  I strongly encourage the public to find highly qualified physicians and surgeons who personally perform these services rather than delegating the service to a nurse who may be permitted by law to perform the injection under the direct supervision of the physician.  The key is that this service is best when performed by someone with a surgical understanding of facial anatomy.  This is not like injecting the flu vaccine into the deltoid muscle.