The Thin Edge of the Wedge: Injectable Cosmetics in Dentistry

BACKGROUND: Scope expansion has been a growing concern among dermatology and medical organizations. There has been a recent push among dental organizations to allow dentists and dental hygienists to perform cosmetic injections into the face and neck. OBJECTIVE: This study analyzes the scope expansion allowing dentists to offer cosmetic injectable procedures, such as botulinum toxin and dermal fillers. MATERIALS AND METHODS: Statutes and rules and regulations from each state were searched using Westlaw Campus Research and BillTrack50. Dental boards were directly contacted for additional clarification of rules and opinions. RESULTS: Starting in 2011, several states authorized this practice, representing a significant redefinition of the practice of dentistry. This expansion of scope has been primarily nonlegislative, with State Boards of Dentistry or Dental Examiners using rulings and regulations in most cases, rather than a statutory redefinition through the legislative process. Furthermore, this scope expansion is broadening down the professional hierarchy, as multiple states now also permit licensed dental hygienists to administer certain cosmetic injections. CONCLUSION: The findings emphasize the dominant role of regulatory boards over the legislature in shaping the scope of practice. Dermatology advocacy organizations have primarily focused on combating pending legislation. However, advocacy efforts should expand to include monitoring and challenging administrative rulemaking processes, although these are more difficult to track.