Very unusual for a stand up paddler to smash into the bottom with his head because he is not “locked” in and can just jump of the board. This board surfer tragically did smash the bottom…
https://www.surfer.com/news/florida-surfer-dies-after-collision-daytona-beach-pier
Surf kayakers and water-skiers are far more likely to flip and have his/her head on the bottom, ironically more likely on small surf days where waves are breaking in shallow water. My fairly new (little over a year) composite helmet has already gotten its share of dinks while protecting my head, especially at my rocky bottom home break.
If you do paddle surfing (or go through surf zones), regard the helmet like your PFD. It is an essential piece of gear. Wear it.
-sing