The appropriate use of physical restraint: considerations

Many people with severe and profound mental retardation have poor oral health and suffer from inadequate oral hygiene. They may also have neurological disorders and limited intellect, which can erect barriers to dental treatment, such as resistive behavior. Lack of an agreed-upon definition of physical restraint by clinicians or governmental and administrative nondental professionals adds to the problem. As a result, controversy and confusion arise when the appropriate use of safety support systems, (i.e., physical restraint) is considered. The purpose of this paper is to address the need for and appropriate use of restraint for a specific population and set of conditions. The appropriate use of restraint permits the administration of oral hygiene, which can help control the level of oral health in this population; if restraint is not used, oral hygiene cannot be accomplished, dental disease increases, and dental neglect can be cited. This paper concludes with several sets of restraint guidelines for appropriate use.