Sir, since the double cohort study published in the BDJ,1 we report a further increase in the number of outpatient trauma cases presenting to the Oral and Maxillofacial Department (OMFS) following collisions involving e-scooters. The majority of e-scooter rentals in our patient cohort were for leisure and social use, with a significant proportion of patients disclosing that they were not wearing a helmet with some also allegedly intoxicated at the time of the incident.

As reported in the Department of Transport National Statistics (DTNS) factsheet, in 2021 there were 1,352 collisions involving e-scooters compared to 460 in 2020, with 1,434 compared to 484 casualties, respectively.2 The Parliamentary Advisory Council for Transport Safety (PACTS) published a report proposing that if the government legalises private use of e-scooters, helmet wearing should be mandatory and drink driving, dangerous or careless riding should be prohibited.3 Computational modelling of e-scooters compared to pedal cyclists found a similarity in the speed of impact between the riders' heads and ground with 40% of impacts with e-scooters to the face. However, the number or severity of facial fractures caused by e-scooter collisions has not been recorded by DTNS.

While the previous study highlighted 12 ED referrals to OMFS during a 16-week period in 2020, a brief overview has identified ten patients similarly involved within only an eight-week period during 2022, 40% of which required surgical management. Fractures identified included Le Fort I, Le Fort II, nasal bone fractures, orbital fractures and zygoma fractures. This data assessment did not include facial lacerations and inpatient trauma data.

A study showed the average cost per patient admitted to King's College Hospital following e-scooter collisions is over £1,000. Although this is not limited to facial injuries, it highlights the cost burden of e-scooter injuries on the NHS.4 We understand the benefits that e-scooters contribute to the joint effort against climate change and reducing pollution within cities. However, it is imperative that public safety is further considered in the government's decisions regarding their legalisation which may include enforcement of mandatory helmet use and prohibition of drink driving, dangerous or careless riding as per PACTS' recommendations.