Botox Update

Dear Dental Hygienists of Utah:

Last week at the Salt Lake Component Meeting, some information was shared about the placement of Botox by dental hygienists here in Utah and the possibility of RDH's having the ability to place botox with the proper training. However, we have recently received a later from DOPL explaining that hygienists placing Botox is against the Utah Dental Practice Act. Below is the copy from that email from Larry Marx to Jessica Atkinson, current UDHA President:

Ms. Atkinson: Among many professions there has recently been a great deal of interest in expanding practices to utilize the innovations of pharmaceutical products for treatment of cosmetic conditions. Two of the current substances are Clostridium botulinum commonly referred to by the trade name Botox and a variety of dermal fillers primarily consisting of hyaluronic acid which is purported to stimulate the production of collagen. The Utah Dentist and Dental Hygienist licensing Board has discussed the use of these substances by dentist. In a June 13, 2008 Board meeting the Board determined the following : "Currently Botox and dermal fillers are accepted practices of dentistry as long as they are for dental procedures. They cannot be used for cosmetic purposes. The use of Botox and dermal fillers is an accepted practice of dentistry when I) it is part of a dentist's treatment plan for a dental condition 2) the dentist has additional education and training, and 3) the dentist has demonstrated competency The use of these materials for non-dental related issues is not within the dentists' scope of practice. Oral and maxillofacial surgeons have training so they can use Botox and dermal fillers."

The Board has not considered the issue of the use of Botox or dermal fillers by Dental Hygienist as being with in their scope of practice. The Dentist and Dental Hygienist Practice Act Utah Code Annotated § 58-69-102 defines the practice of dental hygiene as: (6) "Practice of dental hygiene" means, regarding humans: (a) under the general supervision of a dentist, or under a written agreement with a dentist licensed under this chapter, as provided in Section 58-69-80 1, to: (i) perform preliminary clinical examination of human teeth and gums; (ii) make preliminary instrumental examination of patients' teeth; (iii) expose dental radiographs; (iv) assess dental hygiene status and collaborate with the supervising dentist regarding a dental hygiene treatment plan for a patient; (v) remove deposits, accumulations, calculus, and concretions from the surfaces of human teeth ; (vi) remove toxins and debris from subgingival surfaces; (vii) provide dental hygiene care in accordance with a dentist's treatment plan for a patient;

(viii) take impressions of teeth or jaws except for impressions or registrations to supply artificial teeth as substitutes for natural teeth; or (ix) engage in other practices of dental hygiene as defined by division rule ; (b) under the indirect supervision of a dentist to administer in accordance with standards and ethics of the professions of dentistry and dental hygiene: (i) local anesthesia; or (ii) nitrous oxide analgesia;

In the Dentist and Dental Hygienist Practice Act Rule R156-69-602 other practices of dental hygiene are defined to include laser bleaching and laser periodontal debridement. Neither the Practice Act nor Rule allow dental hygienist to inject Botox or dermal fillers within the scope of practice as a dental hygienist. To do so would be unprofessional conduct.

If you or any of the dedicated professionals practicing dental hygiene need additional information please call or email me at your convenience.

Sincerely, Ma/x Bureau Manager Utah Department of Commerce Division of Occupational and Professional Licensing 801-530-6254