The Impact of Helmet Use on Maxillofacial Injuries in Children During Bicycle, Scooter, and Recreational Sports

Abstract

Background. Maxillofacial injuries are an evolving challenge among children using micromobility devices. While open-face helmets effectively prevent neurocranial injuries, their role in preventing trauma to specific facial thirds, like dentoalveolar injuries, is complex. The expansion of e-mobility also generates new severe trauma patterns.

Aim. To provide a narrative synthesis of recent literature on the impact of helmet use on the risk, severity, and pattern of pediatric maxillofacial injuries. The analysis addresses the "protection gradient," e-mobility safety gaps, and limitations of registry data.

Material and methods. A narrative review of scientific publications (including cohort studies, meta-analyses, and technical reports) published up to 2026 was conducted.

Results. Helmets reduce the overall risk of maxillofacial injuries (RR 0.38 for facial bone fractures). However, a distinct "protection gradient" exists: protection is highest for the upper face but virtually absent for the lower face, leaving the mandible unprotected. While adult cohorts suggest helmets may increase isolated dentoalveolar injury risk, pediatric data remain inconclusive. The rise of e-mobility has led to trauma kinematics resembling motorcycle accidents, compounded by low helmet use (~4%).

Conclusions. Conventional helmets prevent severe craniocerebral trauma but inadequately protect the entire viscerocranium. The increasing mass and speed of micromobility vehicles necessitate updated pediatric protection standards. Lightweight full-face helmets with chin bars show potential, but targeted legislation and further pediatric research are needed.