Orofacial trauma in wheeled non-motorsports


Depending on the type of sport, the rate of sports related orofacial trauma is estimated to range between 11-40%. While reviews of field hockey players and combat and collective sports players have estimates prevalence of 22% and 30 % respectively. Contact sports, winter sports wheeled non-motorsports  have been highlighted as at higher risk of orofacial trauma.

The aim of this review was to identify the overall prevalence of orofacial trauma in wheeled non-motorsports athletes.


Searches were conducted in the Embase, LILACS, Livivo, PEDro, PubMed, Scopus, SportDiscus, Web of Science, Google Scholar, OpenGrey, and ProQuest Dissertations & Theses Global databases with no date or language restrictions. Observational studies evaluating orofacial trauma in wheeled non- motorsport athletes, regardless of the gender, age, and competition level, with quantitative data such as injury type, anatomical site, and sport-related aetiology of trauma were considered. Two reviewers independently selected studies and extracted data with risk of bias being assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data.

The quantitative analysis of results was performed by considering the overall prevalence rates of different types of orofacial injuries in wheeled non-motorsport athletes as the primary outcome. This was presented as means of relative or absolute frequencies and the 95% confidence intervals (CI). Meta-analyses were conducted, with the overall strength of evidence being assessed using  Grading of Recommendations Assessment, Development, and Evaluation (GRADE).


  • 5 studies involving 132,132 athletes were included.
  • 4 studies were considered to have a moderate risk of bias, one study a low risk
  • Mat studies were male dominated with a female participation rate of 17.3%
  • Sports evaluated included skating (2 studies), Cycling/Mountain biking (2 studies) and triathlon.
  • Dental trauma was the commonest type of orofacial injury reported in all studies.
  • Overall prevalence of orofacial injuries in wheeled non-motor sport athletes = 21.7% (95%CI; 8.7 to 34.7%) [4 studies,1232 participants]
  • Prevalence of dental injuries = 7.5% (95%CI; 4.3 to 10.7%) [3 studies, 1090 participants]
  • The certainty of the evidence was considered to be very low.


The authors concluded: –

The cumulative prevalence of orofacial injuries in wheeled non- motor sports athletes was approximately 22%. Among them, the most prevalent type was dental injuries with a cumulative prevalence of 7%. However, the quantity and quality of primary studies on these sports are still small and they have a very low certainty of the evidence, which means that it is not possible to safely extrapolate these results for all wheeled non-motorsport athletes.


The authors have searched a wide range of databases including 5 studies involving 132,132 people most of these (130,900) came from a Scottish Mountain Biking Centre. While most of the studies were considered to be at low risk of bias all the studies used convenience samples so may not be wholly representative.  The large Scottish study did not contribute to the meta-analyses which found the prevalence of orofacial injuries to be 21.7% (95%CI; 8.7 to 34.7%) a figure similar to other sports. Classification of the orofacial injuries varied across the included studies so subgroup assessment of types of injury was not possible.  While the findings do provide an estimate of overall prevalence orofacial trauma and dental trauma in wheeled non-motorsports the quality of the studies means that these estimates are of very low certainty.


Primary Paper

de Oliveira JMD, Pauletto P, Werlich MO, Massignan C, Lehmkuhl KM, Porfírio GJM, Curi Hallal AL, De Luca Canto G. Prevalence of orofacial injuries in wheeled non-motor sports athletes: A systematic review and meta-analysis. Dent Traumatol. 2021 Apr 1. doi: 10.1111/edt.12661. Epub ahead of print. PMID: 33793079.

Review protocol in PROSPERO

Other references

Dental Elf – 15th Jun 2018

Bicycle helmets and facial injuries

Photo Credits

Photo by Chris Henry on Unsplash




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