A patient arrives stating that he was in an accident three hours ago and feels somewhat dizzy. Examination reveals Ellis class II fractures of the anterior teeth. What is the BEST management?

Correct answer: A. Refer the patient to an emergency department for medical evaluation

• A. CORRECT. Dizziness following head or facial trauma is a red flag for intracranial injury — concussion, an evolving subdural or epidural haematoma, or a cervical spine injury. Symptoms that develop or persist hours after the event are particularly concerning, because an epidural haematoma classically follows a lucid interval before deterioration. The dental injury here is not urgent; an Ellis class II fracture involving enamel and dentine without pulp exposure can safely be managed within a day or two once the medical picture is clear. The dizziness cannot wait.
• B. Composite restoration is the correct eventual treatment for an Ellis II fracture, but performing it today means discharging a patient with untriaged post-traumatic dizziness.
• C. Imaging and restoration address the dental problem while ignoring the neurological symptom that could kill this patient. Sequencing is the entire point of the question.
• D. Root canal treatment is not indicated for Ellis class II. Enamel-dentine fracture without exposure is managed by sealing the exposed dentine and monitoring pulp vitality.

Note: Red flags mandating medical referral after facial trauma: loss of consciousness, amnesia, dizziness, persistent or worsening headache, vomiting, visual disturbance, clear fluid from the nose or ears (CSF leak), unequal pupils, or any neurological deficit. Ellis classification for reference: I = enamel only, II = enamel and dentine, III = pulp exposure, IV = non-vital, V = avulsion, VI = root fracture.