Problèmes éthiques soulevés par les soins dentaires chez la personne en situation de handicap

The topic of informed consent takes its place in the discussion of medical ethics. The practice of dentistry on the vulnerable confronts us with the issue of forced treatment. Care is often performed in extreme conditions (crying, restraints, use of tranquilizers). These situations are real cases of conscience. What benefit can we identify an act of care that the patient does not recognize itself as being beneficial? Beyond the direct benefit on oral health, what is the overall benefit for these patients? The objective was to identify the different perspectives and identify sources of disagreement they generate. For this, we conducted a survey of practitioners working in the Handident PACA health Network often faced with these practices to gauge their treatment decisions. A questionnaire of twelve questions, telling clinical scenarios was submitted online anonymously. The sample was 85 people. The participation rate was 38.8%. When the dental care is performed with tears, 72% of practionners continue the dental care. They think they have been beneficient for 2/3 of them but almost 40% of them are not ready to do it again. There are lots of paradox in the answers that show the intensity of the ethical tensions here. Concerning the information given to the patients, most of dentist renounce if the patient is mentally disabled. Post-decision reflection is needed. It is therefore necessary to find new communication media and information in order to have better cooperation from these patients.