In What States Can Dental Hygienists Administer Botox? And Other Botox Questions

Another year has come and gone as we get ready to say goodbye to 2023. The year may have sped by, so hopefully you didn’t miss the exciting changes that transpired for dental hygienists across the country! While there is a lot to celebrate, there have also been some setbacks.

Examining the advancements made by fellow hygienists in their respective states is always advantageous. By doing so, we foster the growth of our profession and advocate for additional responsibilities and skill development.

FAQ: Can Dental Hygienists Administer Botox?

1. Can dental hygienists legally administer Botox?

Currently, only two states—Kansas and Oklahoma—allow dental hygienists to administer Botox, and only under the direct supervision of a dentist. Kansas approved this change in August 2022, and Oklahoma followed in 2023.

2. Why are so few states allowing hygienists to give Botox?

While dentists offering Botox treatments have increased significantly over the last decade, dental hygienists have faced slower progress due to state laws and regulations. Legislative proposals and rule-change attempts in other states have met with resistance.

3. What is the argument for allowing dental hygienists to administer Botox?

Supporters argue that dental hygienists already possess a strong foundation in head and neck anatomy—often more detailed than many healthcare professionals who are already allowed to give injections (such as nurses). Additionally, hygienists are highly trained and regularly perform intraoral injections, a skill set that closely parallels Botox administration.

4. How does a dental hygienist’s training compare to a nurse’s training for Botox?

Many states allow registered nurses to administer Botox with proper certification. Advocates point out that hygienists graduate with in-depth anatomical knowledge and injection experience, which can make them equally qualified—if not more so—than nurses to deliver these treatments safely.

5. What does the future look like for hygienists and Botox?

There is optimism that with time, advocacy, and further legislation, more states will recognize the capability of dental hygienists and allow them to perform Botox under appropriate supervision. Kansas and Oklahoma are seen as pioneering states leading this trend.

6. Do dental hygienists have similar advancements in other clinical areas?

Yes! For example:

• Mississippi and Texas recently passed laws allowing hygienists to administer local anesthesia under a dentist’s direct supervision.
• Other states, like California, are modernizing licensing requirements, such as removing the clinical board exam for new graduates starting in 2024.

Here’s an updated State-by-State Table listing where dental hygienists can legally administer Botox and what the requirements are:

States Where Hygienists Can Administer Botox (As of 2025)

State	Permitted?	Supervision Level	Requirements
Kansas	✅ Yes	Direct supervision	Must be a licensed RDH and meet advanced procedure permit requirements. Kansas law permits dental hygienists (licensed and qualified) to administer Botox under a dentist’s direct supervision per HB 2179 § practice act, requiring clinical training approvals and board licensing Wikipedia+15Teero+15DentalPost+15.
Oklahoma	✅ Yes	Direct supervision	RDH must have ≥2 years of experience plus an Advanced Procedure Permit. Training includes ≥24 hours of didactic/clinical neuromodulator instruction, hold malpractice insurance, and only treat patients of record Legal Information Institute.
Arizona	✅ Yes	General supervision (after qualification)	Initially requires 75 injections performed under direct supervision over 2 years; after qualification, can administer Botox under general supervision (dentist authorizes, doesn’t need to be in same room) Teero.

Additional Insights

• Other states—like Oregon and Nevada—have seen advocacy activity related to expanding RDH roles in Botox administration, but no formal regulation permits it as of mid‑2025 OKDHA+13RDH Magazine+13Teero+13.
• Nearly all other states either explicitly prohibit or do not address hygienist-administered Botox, meaning the practice remains restricted to licensed dentists, nurses, or physician extenders dentox.com+8RDH Magazine+8Teero+8.

Summary

Only three U.S. states currently allow dental hygienists to administer Botox—and all under clear supervision requirements. Kansas and Oklahoma require direct supervision and specialized permits, while Arizona offers a path to general supervision after completing mandated supervised injections.

Dental hygienists interested in pursuing Botox administration should carefully review their state’s dental board regulations, confirm training and licensing requirements, and complete the required certified coursework before offering Botox in clinical practice.