Ethics on the dental treatment of patients with mental disability: results of a Netherlands - Belgium survey.

This study evaluates several ethical dilemmas of by dental practitioners treating persons with mental disabilities (PMD) by dentists in the Netherlands and Belgium. Ethical dental care for PMD is a hot topic. Worldwide different treatment strategies are used in the dental treatment of this patient group. In addition, cultural aspect seems to play an important role in the choices made. The latter can explain the difficulty in creating European and worldwide guidelines on this issue. A questionnaire was sent to dental practitioners interested in treating PMD persons both in the Netherlands and in Belgium including questions on the use of behaviour management techniques, use and attitude towards sedation and physical fixation and the cooperation with other health care personal. Behaviour management techniques and sedation are frequently used. Dentist of the Netherlands and Belgium in general reject the restraint of PMD persons. However, limited use of manual restraint in accordance with the carers and the close surrounding of the patient seems to be accepted. Dental practitioners are sometimes confronted with an emotional dilemma in treating PMD and the majority feels that it is a continuous challenge to obtain optimal result of the dental treatment.