Comparative Evaluation of Dental and Craniofacial Injury Patterns in Conventional and Electric Two-Wheeler Riders in Urban Settings: A Cross-Sectional Survey-Based Study.

OBJECTIVE

To assess and compare the prevalence and pattern of dental and craniofacial injuries sustained by conventional two-wheeler riders versus electric two-wheeler (e-bike/e-scooter) riders involved in road traffic accidents (RTAs), and to evaluate the role of protective gear, riding practices, and behavioral factors on injury outcomes.

MATERIAL AND

METHODS

Six hundred and fifty-two riders (340 conventional two-wheelers, 312 e-bike/e-scooter) were examined and interviewed from an urban setting using a structured questionnaire. Data encompassed demographics, vehicle type, compliance with protective gears, riding behavior and practices, accident characteristics, and oro-facial injury profile. Chi-square, Fisher's exact tests, and descriptive statistics were applied (significance: p < 0.05). A supplementary binary logistic regression, adjusted for vehicle type, helmet compliance, commercial rider status, age group, usual vehicle speed, and pre-ride training, was performed to identify independent predictors of facial injury.

RESULTS

Road traffic accident involvement was significantly more prevalent among e-bike riders than conventional two-wheeler riders (70.8% vs. 47.1%; RR = 1.51; p < 0.001). Among accident cases, facial or oral injuries were significantly more frequent in e-bike riders (72.9%) than in conventional two-wheeler riders (39.4%; OR = 4.13; p < 0.001). Lacerations were the most common injury (39.3%), followed by chipped or broken teeth (21.0%), jaw or facial bone fractures (14.7%), tooth avulsion (9.8%), and tooth displacement/luxation injuries (7.1%). No significant intergroup differences were identified for any individual injury category. Accident rates were similar between commercial and personal use within vehicle groups: E-Bike: 70.6% vs. 71.0% (RR = 0.995; OR = 0.984); Road Bike: 50.0% vs. 45.5% (RR = 1.098; OR = 1.196). Consistent use of protective gear was reported by 72.6% of conventional two-wheeler riders, compared with only 5.8% of e-bike riders (p < 0.001). Pre-ride training was received by 63.8% of conventional riders, compared with 14.7% of e-bike riders.

CONCLUSIONS

Electric two-wheeler riders demonstrate a markedly higher risk of accidents and orofacial injuries compared with conventional riders. After multivariable adjustment, the association between e-bike riding and injury remained significant (aOR = 4.213, p < 0.001). However, correlated behavioral predictors (such as helmet use and pre-ride training) could not be reliably disentangled. Low helmet compliance and urgency-driven riding behavior among delivery riders in quick commerce represent critical characteristics of the e-bike cohort that warrant further investigation.