Oral submucous fibrosis in India: Are we progressing?? (original) (raw)
Related papers
Clinical profile and oral sub mucous fibrosis
Nepalese Journal of ENT Head and Neck Surgery, 2017
Oral submucous fibrosis (OSMF) is an insidious precancerous disease affecting the oral cavity, pharynx and upper digestive tract. OSMF is a debilitating but preventable oral disease. In 1952, Schwartz coined the term atrophica idiopathica mucosa oris to describe an oral fibrosing disease which he discovered in five Indian women from Kenya. 1 Joshi subsequently coined the term oral submucous fibrosis (OSMF). 2 From the end of last century, papers are being published and researches are being conducted and its pathogenetic significance especially as a precancerous lesion is being highly discussed. The transformation rate is as high as 7.6% making OSMF one of the most important precancerous conditions of the oral region. 3 Oral submucous fibrosis is a disease due to a chronic, insidious change in fibro elasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. The symptoms and signs depend on the progression of the lesions and number of affected sites. 4,5 Oral submucous fibrosis (OSMF) is mostly seen in the Southeast Asia. Although nutritional deficiencies 6 and immunological processes may play a part in the pathogenesis, the available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSMF. 4,7,9 Gutkha is widely used which is the preparation of crushed areca nut tobacco, catechu, paraffin, slaked lime and sweet or savory flavorings The severity of trismus can be classified into three grades, depending on the maximal mouth opening (MMO) between upper and lower incisor teeth edges distance. Grade 1 is MMO between 40 and 25 mm; Grade 2 is MMO between 25 and 10 mm; and Grade 3 is MMO less than 10 mm. 10 A wide range of treatment consisting of drug management, surgical therapy, and physiotherapy have been attempted till date; with varying degrees of benefit, but none of them have proved to be a cure. This field remains open for clinical trials and research. 4 The drugs used to treat OSMF were categorized into steroids, enzymes, cardiovascular drugs, antioxidants, vitamins and microelements. There are few high-quality studies available and the present drug treatments are in general empirical and treat only symptoms. 4 Together with a cessation of the betel quid chewing habit before and after therapy, these treatment regimens combined with daily mouth opening exercises were found to be necessary to manage OSMF cases in early and advanced stages of progression. 11 This paper aims to provide an overview on clinical profile of patients with OSMF and its association with different local preparations taken orally. Objectives: Oral submucous fibrosis (OSMF) is an insidious precancerous disease mostly seen in the Southeast Asia. This paper aims to study on clinical profile of patients with OSMF Material and Methods: This cross sectional study was done in department of ENT and HNS, Nepalgunj Medical College and Teaching Hospital. In outpatient department patients with OSMF were ask to fill up a questionnaire that included identification of patient, occupation, their symptoms and habit of taking betel quid or paan, gutkha, etc. Oral cavity was examined and lesion along with its extent and severity was noted. Intra lesional steroid and antioxidant and physiotherapy were main stay of treatment. Results: There were total 136 patients (98 male and 38 female) from 15th Dec 2013 to 15th Jan 2015. Age of patient ranged from 16 years to 53 years and average being 25.6years. Most common preparation taken was gutkha 131(96.3%) followed by betel nut, betel quid etc. Only 24(17.6%) were taking these preparations for less than 1 year. Common presenting complaints were difficulty in opening mouth followed by burning sensation and dryness of mouth. Clinically, the extent of fibrous band was found to be more commonly involving soft palate, pillars and buccal mucosa. Isolated involvement of different region of oropharynx or oral cavity was less common. Correlation of grade of trismus and average duration of taking these different preparations was highly significant. (p=0.008) Conclusions: Oral submucous fibrosis is commonly associated with intake of gutkha having dose dependent relationship with trismus. Further studies are required why only a small fraction of those using betel quid develop the disease.
Oral Sub Mucous Fibrosis (OSMF): Premalignant Threat to Humanity with Special Reference to India
Oral sub mucous fibrosis that leads to the limitation of mouth opening is an uncommon disease affecting a large population in Asian countries especially in Indian subcontinent. The main cause of the disease is excessive consumption of products such as Gutkha, pan masala, khaini, mava etc. made of Areca nut and other tobacco. Several case studies are reported from a large portion of India. However, a proper mechanism and treatment is very limited for this premalignant condition. The review emphasizes towards the basic etiology and treatment aspects with special reference to the case studies reported in India.
Clinico-Pathological Study of 170 Cases of Oral Sub-Mucous Fibrosis
Abstract Introduction: Oral sub-mucous fi brosis (OSMF) is a chronic, irreversible, disease of the oral cavity characterized primarily by burning sensation in the mouth particularly while eating spicy food and progressive development of the inability to open mouth (trismus). Very few clinico-pathological study of OSMF has been published from India and the Indian subcontinent. Materials and Methods: We carried out a retrospective hospital-based clinico-pathological study of 170 patients diagnosed with OSMF attending the outpatient department of Oral and Maxillofacial Surgical Hospital, Rajkot, India and compared our fi ndings with those fi ndings published in earlier studies. Results: In our study of 170 patients with OSMF, male:female ratio was 23.28:1. The highest incidence of OSMF was in the age group 21-30 years (mean 22.70 years), the youngest patient being 8 years old and the oldest 60 years. Inter-incisal distance (IID) varied between 00.00 CM (complete trismus) and 3.70 CMS, average IID being 2.70 CMS. The burning sensation in the mouth was the most common complaint (94.11% patients) followed by vesiculations and ulcerations (83.52% patients). Duration of disease was 2-5 years Buccal mucosa was involved bilaterally in 98.82% patients and palatal mucosa in 92.94% patients. No correlation was found between histopathological and clinical fi ndings. Conclusions: Incidence of OSMF is rising with the younger population getting involved into pathological oral habits such as tobacco and supari (Areca nut) chewing. This article gives an insight into OSMF and adds to its clinico-pathological profi le. Key words: Mouth diseases, Mouth neoplasms, Oral pathology, Oral sub-mucous fi brosis, Retrospective study
Prevalence of oral submucous fibrosis in South Kerala: A cross sectional study
IP innovative publication pvt. ltd , 2019
Introduction: Oral submucous fibrosis is an oral precancerous condition found in the Asian subcontinent mostly India, Pakistan, Sri Lanka and Bangladesh. Usually found among habitual gutkha, arecanut and pan chewers. Aim: 1. Assess the prevalence of OSMF among patients visiting a dental college in South Kerala. 2. To evaluate the association between the prevalence of OSMF with the age, gender, type, frequency and duration of the habit. Materials and Methods: We examined all the patients who visited the Department of Oral Medicine over a period of 24 months. Detailed history and clinical examination was performed. Study design was based on clinical stage, age group, duration, frequency and the type of habit. Results: Out of the total 26476 patients examined 9345 were males and 17131 were females respectively. A total of 19 subjects were diagnosed with OSMF (0.07%). Mean age of the patients with OSMF was 48.63+14.2 with a male predilection of 78.9% and 21.1% females. OSMF was found to be more common (52.6%) in the age group of 41-60 years. Mild OSMF was more prevalent (47.4%) compared to moderate (42.1%) and severe (10.5%). Pan masala was used more than gutkha and the combination of gutkha and tobacco. There was no statistically significant association between the stages, type, frequency and duration of the habit. (p>0.005). Conclusion: Our study revealed a prevalence of 0.07% of OSMF among patients visiting a dental school in South Kerala. Public awareness programs linked with oral premalignant condition and habits may control disease process.
Management of oral submucous fibrosis: A Review
IP Innovative Publication Pvt. Ltd., 2017
OSMF is a chronic disease of the oral cavity, which is more commonly found in the patients of south East Asia and is characterized by the build up of constricting bands of collagen in the buccal mucosa and adjacent structures. The precise cause is unknown but chewing of areca nut and its products, excess use of chilies and spices, poor nutrition, vitamin and iron deficiency have been suggested. Treatment holds option of both non-surgical and surgical approach. Non-surgical management includes multivitamin supplements including lycopene and range of medicines (e.g. intra-lesional injections of steroids, hyaluronidase, human placental extracts, chymotrypsin, pentoxyfilline, collagenase). Surgical intervention includes cutting of fibrous bands, which is used in more extreme cases. Heat therapy (thermodynamics) can also be used for resolving sub-mucous fibrosis.
SciDoc Publishers, 2021
Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Oral Submucous Fibrosis (OSMF) is a disease that frequently occurs among the Indian population. The present study aims to evaluate the prevalence of OSMF among the population visiting an institutional hospital set up. This retrospective study was conducted among the patients visiting the Oral Medicine and Radiology (OMR) department of a private dental college. The data was collected by reviewing the case sheets of the patients diagnosed with OSMF.
Oral Sub mucous fibrosis (OSMF): A Review from Ayurveda Perspective
International Research Journal of Ayurveda & Yoga
Background: Oral sub mucous fibrosis (OSMF) a chronic progressive disorder of oral cavity characterized by inflammation and progressive fibrosis of the sub mucosal tissues. Reported data published revealed an estimate of 5 million OSMF patients in India and increased over past four decades from 0.03% to 6.42%, seen commonly in younger 20-40 years age group. In Ayurvedic classical texts, no any direct references about the disease quoted, can be considered as Anukta Vyadhi (Unexplained disease) and on understanding the disease condition OSMF can be considered as Vata Pradhana Tridoshaja Mukharoga Vyadhi which needs management locally and systemically. Material and Methods:Ayurvedic literature, modern texts as well as the data web-based search engines, journal, were used to search for relevant literature and information. Result:Habit of areca nut or betel quid and tobacco chewing, excessive consumption of chilies, autoimmunity, genetic, environmental factor and dietary deficiencies are...
Oral Submucous Fibrosis: Understanding the Disease through a Case Series
International Journal Of Pharmaceutical And Bio-Medical Science
ARTICLE DETAILS 'Vidari' is a crippling fibrotic disorder affecting mouth commonly seen in India and South East Asia. It's always optimum and highly desirable to beat oral submucous fibrosis(OSMF) before it becomes oral cancer. OSMF is a huge dilemma for clinicians worldwide specifically in south east Asia due to elusive pathogenesis. The main characterstic of OSMF is the build up of fibrous tissue in the sub mucosal layer of mouth, which can lead to a loss of flexibility and movement in mouth and can cause difficulty in opening the mouth and speaking, as well as eating and swallowing.We are presenting a case series of OSMF highlighting the clinically observed features. These features might not be seen together.
Surgical management of oral submucous fibrosis
International Journal of Oral and Maxillofacial Surgery, 2007
condition-"a generalized pathological state of the oral mucosa associated with a significantly increased risk of ' cancer," accords well with the characteristics of OSMF. 3 Described for the first time in detail in the year 1966 by Pindborg and Sirsat, 4 OSMF is now definitely being recognized as a disease of Indian subcontinent occurring more commonly in countries such as India, Pakistan, Shri Lanka, Nepal, China and few countries where Indians have migrated like Europe and North America. Patients present themselves to the clinician treating OSMF with two major complaints: Burning sensation in the mouth, particularly while eating spicy food and progressive inability to open mouth fully (Trismus). The clinical examination invariably reveals multiple oral ulcerations, white blanched oral mucosa, particularly mucosa of cheek and palate, partial or complete trismus and submucosal fibrous bands running in either vertical directions in cheek