Intravenous (i.v.) sedation has become established as an important and preferred alternative to general anaesthesia (GA), in order to overcome difficulties in patient management encountered in the delivery of routine dental treatment of the disabled. However, its potential for the delivery of orthodontics for this group has never been exploited. The present pilot study describes the use of i.v. sedation with propofol to enable the performance of certain complex orthodontic and surgical procedures, which require strict control of the oral environment for prolonged periods, in a group of 10 of the most-difficult-to-manage disabled patients. The use of i.v. sedation provided a satisfactory management modality in these patients, who had previously been referred for GA. The parents reported complete satisfaction and general agreement that the same modality would again be welcomed. I.v. sedation significantly reduces the use of GA and makes treatment more readily available to a larger number of disabled patients.