The risk of head injury in bicycle accidents is reduced among children wearing a helmet. Current helmet design maximises protection in the type of accident most commonly occurring in this study. Legislation enforcing helmet use among children should be considered.

Objectives To investigate the frequency of oral/maxillofacial injuries in children who have had a bicycle incident and to relate this to the wearing of a protective helmet. Design Part of a larger prospective study in which self‐administered questionnaires were completed by each child with bicycle‐related injuries and their parents or caregivers. Setting Two tertiary‐referral children's hospitals (between 1 April 1991 and 30 June 1992) and three general hospitals (between 1 August 1991 and 30 June 1992) in Brisbane. Participants 813 children aged under 15 years who presented to the accident and emergency departments with bicycle‐related injuries. Results There were 321 children (39.5%) who sustained oral/maxillofacial injuries. Of 1355 injuries, 340 (25.1%) were to the facial region. Of the 153 children admitted to hospital for bicycle‐related injuries, 94 (61.4%) had oral/maxillofacial injury as the primary reason for admission (including those with a reduced level of consciousness). Of the 66 children with a reduced level of consciousness, 53 had concomitant facial injuries. The most common oral/maxillofacial injuries were facial abrasions, cuts and lacerations (50.3%); soft tissue injuries to the mouth (30.9%); and dentoalveolar trauma (9.7%). Over half of these children were wearing bicycle helmets. Of the 15 facial fractures (mandibular, nasal, and zygomatico‐orbital), 10 were in children wearing helmets. Conclusions Oral/maxillofacial injuries are frequent among child bicycle riders, even for those who wear Australian Standards‐approved bicycle helmets. Bicycle helmets need design modifications (e.g., lightweight chin protectors) to more adequately protect the face and jaw.