question: Introduction: Since 2008 OMFS trauma and infection cases requiring surgery have been changed by the Recession and now COVID. Mersey Regional OMFS Unit in Aintree Hospital serves a 2 million population. All acute and semi-elective operating for trauma and infection is concentrated in the regional unit. Methods: Data were extracted from Theatre Management Software on operated cases from January 2008 to August 2021. Coding was verified by inspection against the text descriptions of the planned and actual surgery performed. Results: Between Jan 2008 and August 2021 3966 patients with mandibular fractures, 1302 with zygomatic fractures, 429 with orbital fractures and 2801 with dental/cervico-facial infections received primary surgery in the Regional Unit – a total of 8498 operations. Conclusions: Between 2008 and 2019 mandibular fractures operated on fell by almost half (49%). Severe dental infections were relatively unchanged except during the first lock-down when Liverpool Dental Hospital provided a telephone triaged ‘dental extraction service’ (with full PPE) which reduced cases operated on in Aintree by 70%. More detailed trends within the data will be discussed.