Oral submucous fibrosis (OSMF) is a chronic, complex, premalignant condition of the oral cavity,
characterized by an inflammatory reaction and progressive fibrosis of the submucosal tissues. As
the disease progresses, the jaws become rigid to the point that the person is unable to open the
mouth; severe cases may transform into oral cancer.
The condition is associated with areca nut or betel quid chewing, a habit similar to tobacco
chewing, that is practiced predominantly in India. In the initial phase of the disease, the
mucosa feels leathery with palpable fibrotic bands. In the advanced stage the oral mucosa loses
its resiliency and becomes blanched and stiff. The uvula may become bud like. The patient has
reduced mouth opening and burning sensation in the mouth.
First step of treatment is to stop the habit. Depending on the stage of the disease, treatment
may be conservative or surgical. Early stages can be managed conservatively, using a combination
Antioxidant therapy and/or intra-lesional Steroid + Local Anesthetic injections and Oral
physiotherapy. Surgical treatment includes Excision of the fibrotic bands and bilateral removal
of the coronoid process of mandible with or without the placement of inter-positional grafts.
Long term oral physiotherapy is a must to ensure success of treatment.
