Research Article| Volume 58, ISSUE 2, P152-157, February 2020

British Association of Oral and Maxillofacial Surgeons’ National Facial Injury Surveys: hard tissue facial injuries presenting to UK emergency departments

Published:December 19, 2019DOI:


      The British Association of Oral and Maxillofacial Surgeons (BAOMS) and Saving Faces undertook two national prospective surveys 11 years apart. They recorded the facial injuries treated in UK emergency departments and collected data on 14 872 patients. In this paper, which aims to act as a feasibility study for a third national survey of facial injuries, we have reviewed hard-tissue injuries and specifically focused on temporal changes in their morphology. The two sets of directly comparable, categorical, unpaired, cross-sectional data were evaluated independently for statistical significance. In 1997, there were 1977 hard-tissue facial injuries (33%) but in 2008 this had decreased to 1899 (22%) (p < 0.05). In 1997, there were 1315 fractures (22%) and 662 dental injuries (11%) compared with 1462 (17%) fractures and 438 (5%) dental injuries in 2008 (p < 0.05). There were proportional increases in orbital (21%), nasal (139%), and cranial fractures (340%) (p < 0.05). The data showed a small reduction in the total number of hard-tissue injuries, but this was a considerable reduction as a proportion of the total injuries. Analysis of the type and subtype of injury generally pointed towards a reduction in their energy and severity, and to likely changes in mechanism. The project has proved the feasibility of a third national survey of facial injury.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. NHS Digital Hospital accident and emergency activity 2015–2016: summary report. Available from URL: (last accessed 19 September 2019).

      2. NHS Digital. Accident and emergency attendances in England: 2007-2008, experimental statistics. Available from URL: (last accessed 19 September 2019).

        • Wood G.D.
        • Leeming K.A.
        Oral and maxillofacial surgery in accident and emergency departments.
        J Accid Emerg Med. 1995; 12: 270-272
        • Hussain K.
        • Wijetunge D.B.
        • Grubnic S.
        • et al.
        A comprehensive analysis of craniofacial trauma.
        J Trauma. 1994; 36: 34-47
        • Telfer M.R.
        • Jones G.M.
        • Shepherd J.P.
        Trends in the aetiology of maxillofacial fractures in the United Kingdom (1977–1987).
        Br J Oral Maxillofac Surg. 1991; 29: 250-255
        • Hutchison I.L.
        • Magennis P.
        • Shepherd J.P.
        • et al.
        The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption.
        Br J Oral Maxillofac Surg. 1998; 36: 3-13
        • Magennis P.
        • Shepherd J.
        • Hutchison I.
        • et al.
        Trends in facial injury.
        BMJ. 1998; 316: 325-326
        • Muna J.
        • Magennis P.
        • Ridout F.
        • et al.
        The second UK national facial injury survey: the demography, aetiology, nature of injury and treatment.
        Br J Oral Maxillofac Surg. 2009; 47: e58
        • Boffano P.
        • Roccia F.
        • Zavattero E.
        • et al.
        Assault-related maxillofacial injuries: the results from the European Maxillofacial Trauma (EURMAT) multicenter and prospective collaboration.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119: 385-391
        • Gassner R.
        • Bösch R.
        • Tuli T.
        • et al.
        Prevalence of dental trauma in 6000 patients with facial injuries: implications for prevention.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 87: 27-33
        • Andreasen J.O.
        • Ravn J.J.
        Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample.
        Int J Oral Surg. 1972; 1: 235-239
        • Glendor U.
        • Halling A.
        • Andersson L.
        • et al.
        Incidence of traumatic tooth injuries in children and adolescents in the county of Västmanland, Sweden.
        Swed Dent J. 1996; 20: 15-28
        • Tahim A.
        • Patel K.
        • Bridle C.
        • et al.
        The 100 most cited articles in facial trauma: a bibliometric analysis.
        J Oral Maxillofac Surg. 2016; 74 (2240.e1–2240.e14)
        • Jafarzadeh H.
        • SarrafShirazi A.
        • Andersson L.
        The most-cited articles in dental, oral, and maxillofacial traumatology during 64 years.
        Dent Traumatol. 2015; 31: 350-360
        • Boffano P.
        • Kommers S.C.
        • Karagozoglu K.H.
        • et al.
        Aetiology of maxillofacial fractures: a review of published studies during the last 30 years.
        Br J Oral Maxillofac Surg. 2014; 52: 901-906
        • Rallis G.
        • Stathopoulos P.
        • Igoumenakis D.
        • et al.
        Treating maxillofacial trauma for over half a century: how can we interpret the changing patterns in etiology and management?.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119: 614-618
        • Brasileiro B.F.
        • Passeri L.A.
        Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: 28-34
        • Samieirad S.
        • Aboutorabzade M.R.
        • Tohidi E.
        • et al.
        Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: a retrospective study.
        Med Oral Patol Oral Cir Bucal. 2017; 22: e616-e624
        • Andersson L.
        Epidemiology of traumatic dental injuries.
        Pediatr Dent. 2013; 35: 102-105
        • Gassner R.
        • Tuli T.
        • Hächl O.
        • et al.
        Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries.
        J Craniomaxillofac Surg. 2003; 31: 51-61
        • Rashid A.
        • Eyeson J.
        • Haider D.
        • et al.
        Incidence and patterns of mandibular fractures during a 5-year period in a London teaching hospital.
        Br J Oral Maxillofac Surg. 2013; 51: 794-798
        • Walker T.W.
        • Byrne S.
        • Donnellan J.
        • et al.
        West of Ireland facial injury study. Part 1.
        Br J Oral Maxillofac Surg. 2012; 50: 631-635
        • Van Hout W.M.
        • Van Can E.M.
        • Abbink J.H.
        • et al.
        An epidemiological study of maxillofacial fractures requiring surgical treatment at a tertiary trauma centre between 2005 and 2010.
        Br J Oral Maxillofac Surg. 2013; 51: 416-420
        • Motamedi M.H.
        An assessment of maxillofacial fractures: a 5-year study of 237 patients.
        J Oral Maxillofac Surg. 2003; 61: 61-64
        • Children’s Dental Health Survey
        Report 5: Contemporary challenges in children’s dental health.
        (England, Wales and Northern Ireland. Published 19th March 2015. Available from URL (last accessed April 2018))2013
        • Chadwick B.L.
        • White D.A.
        • Morris A.J.
        • et al.
        Non-carious tooth conditions in children in the UK, 2003.
        Br Dent J. 2006; 200: 379-384