Abstract
Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use. A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12-year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures. Twenty-five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02-2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non-helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02-2.31). Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.
Highlights
Bicycling is a popular mode of transportation and form of exercise
The present study shows that dentoalveolar injury is common among trauma patients admitted following bicycling accidents, with a frequency of 8% in the study population
18% of all patients with maxillofacial injury had both facial fractures and dentoalveolar injury. This is comparable to the findings by Boffano et al.,[4] who reported an incidence of 25%, and Lindqvist et al.[34] reporting that 16% of all cyclists with facial fractures had dental injuries
Summary
Bicycling is a popular mode of transportation and form of exercise. About half of the population in the European Union (EU) use a bicycle, and the EU aims to increase bicycle use by 50% from 2019/2020 to 2030.1 Cycling is associated with increased cardiorespiratory fitness, and there is an inverse relationship between cycling and all-cause mortality, cancer, being overweight, and obesity.[2]. Head and facial injuries are among the most common bicycle-related injuries,[3] and bicycling accidents have been cited as the mechanism of injury in 1.1–18% of all facial fractures in several countries.[4] Gassner and colleagues found that 565 of 6000 patients who presented with facial injury at their emergency department had bicycle-related facial injuries. They reported that 50.1% of all sports-related orofacial injuries had concomitant dental injuries.[5]
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