ABSTRACT
The treatment of adult patients with a mental disability can often present the dentist with a variety of complex and perplexing problems. The World Health Organization has described disability as a functional limitation arising from physical, intellectual or sensory impairment, medical conditions or mental illness. Competence is defined as the ability to perform a task, in this instance to make a decision. In this sense competence is recognised as a specific rather than global concept, even though there is a presumption that all adult patients are competent to make decisions for them. Sometimes, patients who lack the capacity to make valid decisions put up fierce resistance against attempts at treatment or even an examination. For care to be provided safely, for both the patient and the dental team, the patient's behaviour will need to be controlled using some means of restraint: physical force, sedation or general anaesthesia.
