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An increase in member calls to CDA Practice Support and The Dentists Insurance Company indicates some confusion around the permitted use of Botox in dentistry.
CDA reminds dentists that the California Dental Practice Act permits the use of Botox and other appropriate products for cosmetic procedures only when used as part of a comprehensive dental treatment plan and for one of the purposes defined in section 1625 of the state’s Business and Professions Code.
California-licensed general dentists are not permitted to offer Botox and dermal filler injections to patients for purely cosmetic purposes. Only oral surgeons who hold an elective facial cosmetic surgery permit can provide these products for stand-alone cosmetic services.
General dentists who offer Botox solely for the purpose of cosmetic enhancement are performing dentistry outside their scope of practice and should refrain from advertising Botox services in their practice and thereby misleading consumers about the availability of Botox for cosmetic purposes alone.
The Dental Board of California clarified the allowable use of Botox in April 2019, at CDA’s request, and there is no movement in California to change the scope of cosmetic dentistry.
The board has pursued enforcement actions against general dentists who perform cosmetic procedures solely for the cosmetic improvement of facial tissues rather than for cosmetic improvements related to dental treatment. Dentists should keep explicit, detailed documentation, including photographs, for procedures performed to improve dental treatment esthetics as they do for all other procedures for dental treatment.
The Dentists Insurance Company policy only covers dentists when they are practicing legally within the scope of their license. Dentists who are performing services that require a special permit but do not have that permit could find themselves without coverage.
Some dentists may be receiving or viewing online or other advertising about continuing education courses on the use of Botox and dermal filler products. Dentists should be wary of these courses.
Courses that teach elective facial cosmetic surgery do not qualify for C.E. credit for license renewal in California unless the licensee has an elective facial cosmetic surgery permit. Dentists should confirm the scope of their license prior to taking courses on Botox-related procedures used in cosmetic dentistry.
Additionally, some course descriptions and advertising infer or imply that the procedures taught may be covered by the attendee’s liability carrier. Although marketed to dentists, these course programs are not the source of authority for determining if dentists can perform the procedures and whether their liability carrier will provide coverage. As noted above, TDIC policy only covers dentists when they are practicing legally within the scope of their license.