CODE Register of Injectable Cosmetic Providers

Lorna Jackson
By Lorna Jackson

Lorna was Editor of Consulting Room (, the UK's largest aesthetic information website, from 2003 to 2021.

Paul Mendlesohn, Chief Executive of CODE, the Association of Dental Practice recently noted on his blog that Dental Hygienists have been refused entry to the Quality Mark Scheme for the Independent Healthcare Advisory Services’ Register of Injectable Cosmetic Providers.

He asks; is the IHAS shooting itself in the foot with this approach?

It is true that the new shared regulation scheme has got off to somewhat of a rocky start since its launch to the industry back at the start of April. With news of a delay to the public awareness campaign from the originally planned May launch to a mid-July slot, and accounts of issues with the online registration process which has caused disquiet and disappointment amongst early adopters.

Despite this the IHAS is keen to reassure us all that the number of registered providers is building and they urge service providers to join up to take advantage of commercial gains that the Quality Mark will bring, ahead of the public launch.

“The reason for the delay with the launch to the consumers is that many providers are finding the process very robust, hence they are taking time to get evidence of their policies together for the self assessment process.”; said Sally Taber, IHAS Head.

Many industry participants are still reticent about signing up until the scheme is proved worthwhile, both financially and from a self-regulation perspective, so some would argue that excluding certain disciplines, such as Dental Hygienists is counter-productive to making the scheme work.  Additionally it is felt that the reasons given by the IHAS for the imposed ban of Dental Hygienists are somewhat unclear, particularly when they can obtain medical malpractice insurance for the provision of cosmetic injectables from service providers such as Hamilton Fraser.

Mike Glanvile from HFIS said; “Three years ago we found that the number of requests for insurance from dental hygienists undertaking Botulinum Toxin and Dermal Fillers was increasing. Following in-depth research into the training and qualifications that hygienists were expected to attain, coupled with our own non-medical research, risk assessments and guidance from respected industry experts, we felt that hygienists demonstrated a level of competence that satisfied our underwriting criteria.”

“Three years on, and with the level of complaints from patients treated by dental hygienists remaining on par with other medical professionals offering similar treatments”, continued Mike, “we are currently considering widening our acceptance criteria further to include dental hygienists undertaking procedures without the supervision and guidance of a dentist, such is our commitment to this sector of the industry.”

In line with the obvious thumbs up from the insurers, Paul Mendlesohn argues that; “hygienists have excellent clinical and cross-infection skills, training in medical emergencies and can administer dental anaesthetic injections, after a short course. In addition, there are established team working skills; hygienists work closely with the dentist which gives an ideal scenario for skin treatment; and this frees up the dentist for more advanced treatments.”

Yet it cannot be ignored that Dental Hygienists would have the same problem currently facing aesthetic nurses, who aren’t prescribers when it comes to the administration of botulinum toxins.

When questioned regarding this issue, Sally Taber noted;

“IHAS have consulted with the Director of Standards at the General Dental Council regarding admitting Dental Hygienists/Therapists onto the Register.

The GDC are considering the accountability of Dental Hygienists/Therapists participating in the Scheme and will be preparing documentation to ensure in particular that the accountability to a Dentist is ensured. This will be similar to the General Medical Council who has issued advice on Remote Prescribing, as has the Nursing and Midwifery Council to all its registrants on the register.

IHAS has agreed with the GDC to revisit the decision re: Dental Hygienists/Therapists in December 2010 when the standards will be reviewed.”

CODE plan to lobby the IHAS to accept Dental Hygienists to the quality mark registration.

Are you a Dental Hygienist currently offering cosmetic injectables who would like to join the register? Or are you a Doctor, Dentist or Nurse with a view on this issue?  We’d love to hear your thoughts and opinions on this topic so please do comment below.


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