Serious road accidents come with a familiar refrain for Akbar Lightbourne: “I thought I could have made it home.”

“They all say it,” the surgeon, who specialises in damage to the face and jaw, said of drivers who decided to gamble while impaired — and lost.

Dr Lightbourne’s message is blunt: “Stop thinking that way — you’re not going to make it home. You’re just playing the numbers. Sooner or later, something will happen.”

Aside from urging motorists to slow down and refrain from drugs or alcohol, Dr Lightbourne calls for bike riders to protect themselves before they ride, with full-face helmets.

As a maxillofacial surgeon, he regularly bears witness to the graphic damage inflicted by Bermuda’s unforgiving roads.

According to Smiles Inc, the practice at which he works, the island sees two to three cases of serious facial trauma a week.

“In approximately 20 per cent of cases I see, the patient wore a proper helmet and the injuries were not severe. We’re able to restore a broken nose, and the patient will do fairly well.

“But in 80 per cent of cases, they weren’t wearing a proper helmet.”

Drastic facial and jaw injuries can have permanent debilitating effects, from lost eyesight, eating and breathing problems, and chronic pain that worsens in later decades.

“A lot of people have to live with these injuries and suffer long-term problems. It doesn’t just go away.”

Full-face helmets — not to be confused with full-face visors — offer chin protection and better coverage of the head that “dramatically reduce” the effects of a crash.

But the bulkier helmets, with their higher price, can prove a tough sell.

“It’s no fault of the distributors that there is a lack of variety and an expense,” Dr Lightbourne said. “But with the help of the Road Safety Council, I think that suppliers may offer a better variety at a better cost.”

Popular brands favoured by young people often fall short on protection, and Dr Lightbourne said in his talks at schools that he was often “shocked” that new drivers failed to consider selecting safety first.

“We need to teach and advocate functionality, which is hard,” he told The Royal Gazette, likening the choice to selecting “between a Prius and a Mustang”.

“Educating our future adults on this silent epidemic” is crucial to cut down on avoidable injury — and any helmet should be tightly buckled to prevent it flying off in a crash.

Ideally, helmets should be replaced at least every two years, especially if dropped — and riders must learn to avoid speed, and especially impaired driving.

“It involves exposing younger generations and educating them more than we do, in different ways,” he said. “Obviously, how we’ve been doing it is not working.”

While he applauds A Piece of the Rock, the new documentary exposing the toll taken by dangerous driving, Dr Lightbourne said watching it to the end had proved too much to bear.

“I knew a lot of them, and I became very emotional,” he said.

Road safety expert Joseph Froncioni confirmed that half-shell helmets offer “very little protection from facial injuries”, and noted the wide selection of full-face helmets available.

“However, the added protection of a full-face helmet is often negated by the misuse of those helmets,” Dr Froncioni said.

He explained that the most popular models are equipped with “a face gate that allows the frontal portion of the helmet to be opened for ease of donning”.

“This is especially helpful for those riders who wear spectacles. Unfortunately, because of our climate, a very large proportion of riders who purchase full-face helmets with the face gate feature end up riding with the face gate open for better ventilation.”

The practice is “extremely dangerous”, Dr Froncioni said, since the face gate is not a component designed to break off.

“In a crash, the open face gate can act as a significant lever arm, amplifying forces on the cervical spine and potentially causing severe or fatal neck injuries,” he said.

“This risk is clearly stated in the information that is included with the helmet. However, it seems to be considered ‘cool’ to ride with the face gate open.

“So, while full-face helmets are much safer in principle, their misuse negates some of the benefits.”