Ala. Admin. Code r. 270-X-2-.25

Current through Register Vol. 43, No. 1, October 31, 2024

Section 270-X-2-.25 - [Effective 11/14/2024] Administration of Botulinum Toxin and Similar Treatments by Dentists

(1)General. This Rule defines and regulates the scope of dentistry as applied to the administration of botulinum toxin, dermal fillers, and similar agents by dentists in Alabama for therapeutic and/or esthetic purposes. This Rule displaces and supersedes all previous formal or informal guidance, or opinions expressed by the Board on the subject matter covered by this Rule, including but not limited to informal opinions issued by the Board in the absence of public notice and comment procedures on February 10, 2023, January 13, 2023, January 13, 2022, December 2, 2021, February 13-14, 2020, and July 2010.

(2)Definitions. As used in this Rule:

(a) "Human mouth, teeth, gums, jaws, and adjacent structures" includes the oral cavity, teeth, gingiva, cheeks, jaws, temporomandibular joint, lips, head, and neck. In the case of covered therapeutic procedures only, "human mouth, teeth, gums, jaws, and adjacent structures" also includes the points of origin of muscle and fascia which insert into the head and neck.

(b) "Covered esthetic procedure" means the administration of botulinum toxins, any neuromodulator derived from Clostridium botulinum, dermal fillers (including but not limited to collagen and any resorbable substance injected subcutaneously or intracutaneously), hyaluronic acid, platelet-rich plasma, platelet-rich fibrin, calcium hydroxylapatite (CaHA), poly-L-lactic acid, polymethylmethacrylate (PMMA) fillers, and similar medicaments, agents, and/or procedures, the principal purpose of which is to reduce the appearance of lines, wrinkles, or grooves in the skin.

(c) "Covered therapeutic procedures" means any therapeutic use of the agents referenced in subsection (2)(b), including but not limited to the treatment of TMJ disorder, dysfunction, or syndrome and orofacial pain.

(d) "Medical facility" means a clinical setting properly equipped for the performance of dental or medical procedures and where universal infection control precautions can be maintained, including a dental office, medical office, hospital, nursing home, outpatient surgery center, or similar setting, but excluding mobile and portable dental units.

(3)Requirements for Administration of Covered Esthetic or Therapeutic Procedures by Dentists. Within a medical facility, a dentist may administer covered esthetic or therapeutic procedures in the human mouth, teeth, gums, jaws, and adjacent structures to treat disease, pain, deformity, deficiency, injury, or physical condition in the area of treatment, subject to the following requirements:

(a) Before administration of any covered esthetic or therapeutic procedure, the dentist shall establish a bona fide dentistpatient relationship with the patient, obtain an appropriate medical and dental history, perform an appropriate clinical examination, and make an appropriate record of treatment.

(b) The dentist shall comply with all laws and professional standards governing the dentist-patient relationship, including but not limited to rules governing patient records, standards for infection control (e.g., universal precautions), and rules governing continuity of care and patient abandonment.

(c) The dentist shall personally perform the covered esthetic or therapeutic procedure.

(d) The dentist shall have successfully completed a board-approved training covering at least the following topics:

1. The anatomy of the head and neck;

2. Neurophysiology of the head and neck, including facial tissues, parasympathetic, sympathetic, and peripheral nervous systems, and facial architecture;

3. Patient selection, including indications and contraindications;

4. Pharmacological effects and contraindications, including potential drug interactions;

5. Safety and risk issues particular to the agents to be used, including management of adverse reactions and complications;

6. Preparation and delivery techniques;

7. Patient assessment, consultation, and informed consent; and

8. Live, hands-on training.

Ala. Admin. Code r. 270-X-2-.25

Adopted by Alabama Administrative Monthly Volume XLII, Issue No. 12, September 30, 2024, eff. 11/14/2024.

Author: Board of Dental Examiners of Alabama

Statutory Authority: Ala. Code 1975, § 34-9-43 (10), § 34-9-43.2