State by State Dental Botox Regulations (USA)

Laws regarding who can administer Botox and dermal fillers vary so much from one state to the next that it can be hard to know whether you’re even allowed to use it, and if so, under what circumstances. The Medicines and Healthcare products Regulatory Agency (MHRA) regulates a wide range of materials from medicines and medical devices to blood and therapeutic products and services that are derived from tissue engineering. MHRA also regulates the use of Botox. In the United States, plastic surgeons, nurses, internal medicine physicians, ophthalmologists, dermatologists, podiatrists, OB-Gyns, medical estheticians, and physicians’ assistants can administer Botox depending on individual state laws. Although the use of Botox in all facial therapies was pioneered by Dr. Howard Katz (a dentist), there are still some antiquated regulations in place in certain states.

Following is an easy to understand summary of the dental laws in 27 states, stipulating who can inject Botox.

Alaska 

Who can give Botox injections in Alaska? The dental board states that dentists may perform any cosmetic procedure provided it is part of a dental treatment plan, but not as as standalone treatments.

Arkansas

Permits are not issued by the board for botulinum toxins or dermal fillers, and dental materials of all kinds are unregulated.  Because dentists are offering the treatments more often, the board has outlines some requirements for their use.  In order to administer Botox or dermal fillers, dentists must complete a course of training from either a dental institution approved by the Commission on Dental Accreditation of the American Dental Association or a continuing education course that includes instruction on:

• Consulting with and assessing patients for the use of Botox and dermal fillers;
• Uses and contraindications for these treatments;
• Safety and risks associated with botulinum toxins and injectable dermal filler treatments;
• How to prepare and administer the products for the best results;
• How to use dermal fillers to augment and conclude esthetic dental treatment;
• Using botulinum toxin to treat disorders of the temporomandibular joint and teeth grinding;
• How to recognize and manage adverse reactions and treat potential complications;
• How to evaluate the patient for the best outcomes, both therapeutic and esthetic;
• How to incorporate Botox and dermal fillers into dental and esthetic treatment plans;
• Hands on training on live patients, including diagnosing, planning treatments, dosing and administering Botox and dermal fillers;

The administration of Botox and dermal fillers is allowed only in dental offices observing universal precautions set forth by the Federal Centers for Disease Control.  The treatments may only be administered by dentists, dental staff are prohibited.

Continuing education courses must be either approved or sponsored by at least one of the entities outlined in LAC 46:XXXIII.1615.

Connecticut

Who can inject Botox in Connecticut? The dental board permits dentists only to perform procedures related to the mouth, structures in the mouth, and the jaw.  Procedures outside the area of the mouth or jaw may not be performed by dentists.

Delaware

The Board of Dentistry and Dental Hygiene has responded to requests for recommendations on Botox and dermal fillers by stating that it is unauthorized to offer recommendations.  The Board has observed that neither licensing law nor the Board’s rules and regulations expressly discuss the treatments.  Because the rules do not contain any provisions regarding these treatments, the Board has responded to requests by stating that determinations regarding whether use of Botox violates the law or the Board’s rules and regulations must be made on a case by case basis based on facts of the alleged violation that are presented to the Board.

Florida

Dentists may prescribe medications within legal limitations; perform surgical procedures that are part of his or her practice and in which he or she has been trained; administer anesthesia or sedation within legal limits and use those appliances that may be needed for proper dentistry practice.

Idaho

Who can administer Botox in Idaho? The Board of Dentistry has ruled that the the laws regarding dental practice are broad enough to permit dentists to administer Botox and dermal fillers as part of their dental practice.  They have also ruled that dentists have a duty to obtain adequate training to ensure competence in any procedure they would like to perform.

Iowa

The law restricts dentists to providing treatments that are defined by the scope of dentistry.  Dentists are allowed to examine, diagnose, and treat patients suffering from disease, disorders, injuries, deformities or defects in and around the mouth, including teeth, gums, jaws and related structures and tissue.  Appropriate treatments include medications, appliances or surgery.  Dentists must have appropriate education, training and experience in any method used, and the use must be directly related to dental practice.  Rules require that a dental exam be performed and medical history obtained prior to prescribing or administering any medication.

Using these laws as a guide, the Board has ruled that a dentist may use Botox and dermal fillers, provided the use is directly relevant to dental practice AND the dentist has obtained and completed appropriate training.  Current regulations permit only those dentists who have completed a residency program that is accredited by the American Dental Association and includes administration of Botox and dermal fillers as part of its education and training.

Kansas

Who is permitted to give Botox injections in Kansas? The dental board has determined that injections intended to reduce appearance of aging is not appropriate to the practice of dentistry.  Any dentist who performs injections other than for dental purposes are not observing proper standards of dental care and are subject to disciplinary action.

Louisiana

Permits are not issued for the use of Botox or dermal fillers, but the dental board has outlined certain requirements.  Prior to using Botox or dermal fillers, the dentist must have successfully completed training offered by an institution accredited by the Commission on Dental Accreditation of the American Dental Association or a continuing education course that includes instruction in:

• Consulting with and assessing patients for the use of Botox and dermal fillers;
• Uses and contraindications for these treatments;
• Safety and risks associated with botulinum toxins and injectable dermal filler treatments;
• How to prepare and administer the products for the best results;
• How to use dermal fillers to augment and conclude esthetic dental treatment;
• Using botulinum toxin to treat disorders of the temporomandibular joint and teeth grinding;
• How to recognize and manage adverse reactions and treat potential complications;
• How to evaluate the patient for the best outcomes, both therapeutic and esthetic;
• How to incorporate Botox and dermal fillers into dental and esthetic treatment plans;
• Hands on training on live patients, including diagnosing, planning treatments, dosing and administering Botox and dermal fillers;

The administration of Botox and dermal fillers is allowed only in dental offices observing universal precautions set forth by the Federal Centers for Disease Control.  The treatments may only be administered by dentists, dental staff are prohibited.

Continuing education courses must be either approved or sponsored by at least one of the entities outlined in LAC 46:XXXIII.1615.

Maryland

Who can inject Botox in Maryland? Dentists are allowed to prescribe medications for treatments that are within the scope of dental practice and must have adequate training in administration of Botox and other medications in compliance with the Code of Maryland Regulations (COMAR).

Massachusetts

There are currently no regulations regarding Botox and dermal fillers, but a task force has been appointed to gather information so that policies and guidelines may be established.

Mississippi

Who can administer Botox in Mississippi? Currently only Oral and Maxillofacial surgeon are allowed to administer Botox and dermal fillers.  In 2007, the dental board met to address the question of whether dentists are or should be allowed to perform cosmetic procedures outside the oral cavity regardless of whether the dentists holds a general or specialty license.  The board ruled that these procedures may only be performed by surgeons who have completed a residency in oral and maxillofacial surgery that is accredited by the American Dental Association.

Missouri

The appropriate scope of dental practice involves treating disease, deformity, injury or condition of the teeth or mouth and related structures, including lesions in the oral area.  No guidelines currently exist regarding administration of Botox or similar medications.

Nevada

Who can give Botox injections in Nevada? Botox and dermal fillers for cosmetic uses are outside the appropriate scope of practice for a dentist and therefore dentists are not permitted to perform these injections for cosmetic purposes.

New Hampshire

Dentists may perform such procedures as fall under the scope of dental practice as defined by NH RSA 317-A:20 and for which they are adequately trained.

New Mexico

Who can inject Botox in New Mexico? The Board of Dental Health Care does not currently regulate the use of Botox or dermal fillers by dentists.  The board is considering the issue and is expected to pass rules on these medications in the near future.

New York

Use of Botox and dermal fillers is allowed provided it is used as a part of treatment for dental reconstructive treatment, otherwise is not permitted by dentists. (see our New York Botox training program)

North Carolina

The board has ruled that any cosmetic or dermatological procedure that is not associated with dental treatments is outside the scope of dental practice.

Pennsylvania

Who can administer Botox in Pennsylvania? Board of Dentistry does not currently have any policies regarding use of Botox and dermal fillers by dentists, though a policy has been proposed and is under consideration.

South Carolina

There are currently no regulations regarding use of Botox by dentists.

South Dakota

Who can give Botox injections in South Dakota? There are currently no regulations regarding use of Botox by dentists, though such a policy may be addressed in the near future.

Texas

The laws regarding dental practice do not specifically regulate cosmetic procedures, but does limit the scope of dentistry to procedures involving teeth, mouth, gums, jaws and associated structures.

Virginia

Who can inject Botox in Virginia? The law limits cosmetic procedures outside the mouth to oral and maxillofacial surgeons holding specific cosmetic procedure certification issued by the Board of Dentistry.  Dentists may, however, administer Botox as part of a dental treatment.

Washington

ere are no laws specifically regarding Botox or dermal fillers, though the law does limit dentists to prescribing and administering medications as part of dental treatment only.

West Virginia

Who can administer Botox in West Virginia? Use of Botox and dermal fillers is allowed by dentists only in the oral and maxillofacial region and must be specifically trained in the procedures.

Wisconsin

Botox and dermal fillers may be administered for therapeutic and esthetic treatments that fall within the practice of dentistry as outlined in s. 447.01 of the Wisconsin Statutes.  Dentists must complete appropriate training prior to performing such services.

Wyoming

The Board of Dental Examiner has neither addressed use of Botox, nor do any related rules or regulations.

 

 

References:

Dental Boards Organization (2012).Dentists’ Botox Use Laws. Retrieved July 22, 2014 from https://www.dentalboards.org/PDFS/2012BackgroundBotox.pdf

*The data on this page is informational only, and may not be current. Please check with your dental state board for up to date regulations before injecting Botox.