Oral submucous fibrosis in children: an alarming condition and challenges in management

Oral submucous fibrosis (OSF) is a well-documented potentially malignant condition. It affects most commonly the adult patients of India and Indian subcontinent, only few cases affecting children have been reported in the literature. This paper presents three cases of OSF below the age of 12 years and reviews the aetiology, clinical presentation, treatment modalities in children with improved follow-up results. Clinical features like restricted mouth opening, burning sensation and history of betel nut chewing helps in the diagnosis of the patients, which can be confirmed by histopathological examination. Conservative management and oral physiotherapy in children help in improved mouth opening. Counselling the children, their friends and parents also plays a vital role. The present paper highlights that children on a larger scale are using tobacco products and further studies are required with larger sample size.

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158 Oral Submucous Fibrosis in A 2-Year-Old Girl Due to Chewing BIDI Stubs

British Journal of Surgery ◽

10.1093/bjs/znab134.196 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

D S Sahni ◽

D Desai ◽

G Prasad ◽

S Ramsaha

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Symptomatic Improvement ◽

Aetiological Factor ◽

Contributing Factors ◽

Oral Ulcers ◽

History Of ◽

Submucous Fibrosis ◽

Background History

Abstract A 2-year-old girl, complaining of a gradual increase in the restriction of the mouth opening for 3 months, was referred to the Otolaryngologists based on background history of recurrent oral ulcers. The local examination showed the presence of oral ulcers on the cheek in addition to abnormal oral mucosa which appeared blanched, opaque and fibrotic. This was clinically diagnosed as Oral Submucous Fibrosis, owing to classical presentation and the lack of systemic features. A detailed social and family history revealed that the father of the child used to smoke BIDI, a traditional form of nonfiltered cigarette. The child used to play with the burnt stubs and keep them in her mouth, chewing them for long durations. This was assumed to be the aetiological factor behind the development of the pathology, in absence of any other contributing factors. The patient was treated conservatively, and symptomatic improvement was noted on follow-up. This is the youngest reported patient with OSMF, and this case history brought an unusual aetiological factor to the fore.

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Nasolabial Flap in the Management of Oral Submucous Fibrosis

Journal of Mahatma Gandhi University of Medical Sciences and Technology ◽

10.5005/jp-journals-10057-0007 ◽

2016 ◽

Vol 1 (1) ◽

pp. 27-29

Author(s):

Vaishali Jamdade ◽

Amit LNU

Keyword(s):

Surgical Treatment ◽

Physical Therapy ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Oral Carcinoma ◽

Treatment Modalities ◽

Nasolabial Flap ◽

Mahatma Gandhi ◽

Premalignant Condition ◽

Submucous Fibrosis

ABSTRACT Oral submucous fibrosis (OSMF) is a premalignant condition associated with restricted mouth opening. Oral submucous fibrosis is poorly understood and unsatisfactorily treated disease. Serious complication is the risk of development of oral carcinoma. Different treatment modalities like medical, surgical, physical therapy or combination are used to improve the condition of the patient. Surgical treatment is usually indicated in late and irreversible stage of the disease. Successful use of nasolabial flap in the management of OSMF is presented. How to cite this article Jamdade V, Sharma S, Chitlangia P, Amit. Nasolabial Flap in the Management of Oral Submucous Fibrosis. J Mahatma Gandhi Univ Med Sci Tech 2016;1(1):27-29.

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Effectiveness of Pentoxifylline Therapy for Management of Oral Submucous Fibrosis

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40228 ◽

2022 ◽

Vol 19 (1) ◽

pp. 51-54

Author(s):

Dwarika Prasad Bajgai ◽

Bela Agrawal ◽

Abadhesh Yadav

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Burning Sensation ◽

Oral Disease ◽

Medical College ◽

Adjacent Structures ◽

Group A ◽

Submucous Fibrosis ◽

Group B

Introduction: Oral submucous fibrosis is a chronic oral disease characterized by progressive buildup of constricting collagen bands in the cheeks and adjacent structures of the mouth due to chewing of areca nut. This can severely restrict mouth opening and tongue movement causing pain and burning sensation in the mouth. Aims: This study evaluates the efficacy of pentoxifylline in the management of oral submucous fibrosis. Methods: A hospital-based study, conducted in the dental outpatient department of Nepalgunj Medical College from October 2019 to September 2020. Forty-nine patients who were diagnosed histopathologically with oral submucous fibrosis were included. The patients were divided into two groups. In group A, patients were given, 200 mg thrice daily for first 30 days, then dose hiked to 400 mg thrice daily for two more months. Group B patients received treatment with multi-vitamin capsules (B-complex one capsule before sleep daily) for three months. All patients were followed up for six months and were assessed for maximum inter-incisor opening, pain on opening of mouth and burning sensation. Results: There was no statistical difference in mouth opening at baseline and first follow up. The mouth opening was significantly more in group A compared to group B from second follow up which persisted till third follow up (p <0.05). Pain and burning sensation significantly reduced in group A compared to group B from 2nd follow up which persisted till 3rd follow up (p <0.05). Few patients had nausea, dyspepsia and vomiting during treatment in group A which resolved within a few days without the need for cessation of the drug. Conclusion: Pentoxifylline can bring about significant clinical improvements in the symptoms of oral submucous fibrosis like mouth opening, pain and burning sensation, thereby improving the quality of life of the affected individuals.

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Prevalence of OSMF cases in various age groups correlating with habits and treatment outcomes in Saveetha Dental College: A prevalence study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl3.3519 ◽

2020 ◽

Vol 11 (SPL3) ◽

pp. 1799-1804

Author(s):

Aklesha Behera ◽

Abilasha R ◽

Pratibha Ramani ◽

Gheena S ◽

Hannah R

Keyword(s):

Indian Subcontinent ◽

Oral Submucous Fibrosis ◽

Age Groups ◽

Mouth Opening ◽

Study Groups ◽

Patient Records ◽

Tobacco Products ◽

Precancerous Condition ◽

Male Preponderance ◽

Submucous Fibrosis

Oral submucous fibrosis is a chronic, progressive, scarring precancerous condition of the oral cavity seen predominantly in the Indian subcontinent and southeast Asia. OSMF is caused by consumption of areca nuts and tobacco products. Patients suffer from trismus and other related problems. Interincisal mouth opening ranges between 24 to 55 mm in this study, hence making the study groups between I to III. The aim of the study is to find a correlation between age, habits and treatment outcome in OSMF patients. Data was procured from patient records of 86000 patients who visited from between June 2019 and March 2020 and analysis was done. Age is between 21 to 64 years. Male preponderance is seen 92.4% pan chewing is common (35.9%) Interincisal opening is between 24 to 55 mm, making the OSMF grade I and II. OSMF affects people aged 21 to 64 years and the interincisal mouth opening is between 24 to 55 mm, making the grades I and II.

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Comparative study of rebamipide & betamethasone in managing stomatopyrosis in oral submucous fibrosis (OSMF) patients

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.ijooo.2021.049 ◽

2021 ◽

Vol 7 (3) ◽

pp. 157-160

Author(s):

Md. Asdullah ◽

Nasir A Salati ◽

Masood H Khan ◽

R K Tiwari ◽

Pradhuman Verma ◽

...

Keyword(s):

Indian Subcontinent ◽

Oral Submucous Fibrosis ◽

Age Groups ◽

Mouth Opening ◽

Standard Of Care ◽

Burning Sensation ◽

Intralesional Injection ◽

Vas Score ◽

Group I ◽

Potentially Malignant

Oral sub mucous fibrosis (OSF) is commonly seen in the Indian subcontinent affecting individuals of all age groups. It is a potentially malignant disorder caused almost exclusively by the use of smokeless form of tobacco products. The malignant transformation rates vary from 3 to 19%. The standard of care (SOC) in managing OSF includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. To evaluate the efficacy of rebamipide to reduce the oral burning sensation associated with OSMF as compared to coventional Betamethasone intralesional injection.After providing information about the study and obtaining consent, these individuals were divided into two groups of 15 each using random sampling method. Patients in the rebamipide group (group I) were prescribed 100 mg tablets of rebamipide thrice a day for 21 days. The other 15 patients (group II) were given SOC, intralesional betamethasone injection 4 mg/mL once a week for 4 weeks. Visual analog scale (VAS) with 11 points (0–10) was used to assess burning sensation in the first visit, and change in the burning sensation was assessed after every 7th day on VAS in both the groups.: The improvement in the VAS score in each visit was significant (p < 0.05) in the 1st, 2nd, 3rd, and 4th visit. The VAS score between the 4th and 5th visit failed to reach a statistically significant level (p > 0.05). The VAS score was significantly different between the rebamipide and betamethasone group (p > 0.05) in third & fourth visit. Our results showed that rebamipide was equally efficacious if not better than the betamethasone intralesional injections.

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Emancipators in oral sub mucous fibrosis: An update

International Journal of Dentistry Research ◽

10.31254/dentistry.2021.6207 ◽

2021 ◽

Vol 6 (2) ◽

pp. 59-64

Author(s):

Subharina Mahapatra ◽

◽

Manjula Hebbale ◽

Amit Mhapuskar ◽

Richa Jain ◽

...

Keyword(s):

Surgical Treatment ◽

Literature Search ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Treatment Modalities ◽

Established Method ◽

Pharmacological Agents ◽

Cochrane Database ◽

Submucous Fibrosis ◽

Oral Sub Mucous Fibrosis

Oral submucous fibrosis is a chronic insidious oral mucosal condition causing trismus and reduced mouth opening and it is affecting predominantly Indian and other Asians. The treatment of trismus requires combination of pharmacological agents, surgical therapy and physiotherapy, the latter is essential for preventing relapse due to postoperative inactivity and scarring as well as for improvement of mouth opening. Computerized literature search was performed from 1993 till 2021 to select eligible articles from the following databases: PUBMED [MEDLINE], SCOPUS, SCIENCE DIRECT, and COCHRANE DATABASE using specific keywords. The search was limited to articles published as full text in English, which were screened by two reviewers for eligibility.This article describes in depth about various appliances, devices used in oral submucous fibrosis. The devices can be used along with pharmacological and surgical treatment modalities or can be used alone. Mouth exercise is also well-established method to improve mouth opening and also to prevent postsurgical relapse. This article is one of the rare article that describes all the appliances together either directly used or indirectly used for the case of microstomia due to oral sub mucous fibrosis.

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The Use of Diode Laser in Treatment of Oral Submucous Fibrosis

Journal of Mahatma Gandhi University of Medical Sciences and Technology ◽

10.5005/jp-journals-10057-0020 ◽

2016 ◽

Vol 1 (2) ◽

pp. 79-81

Author(s):

Amit LNU ◽

Ashish Soni ◽

Prateek Agarwal

Keyword(s):

Surgical Treatment ◽

Diode Laser ◽

Local Anesthesia ◽

Indian Subcontinent ◽

Diode Lasers ◽

Oral Submucous Fibrosis ◽

Treatment Modalities ◽

Success Rates ◽

Precancerous Condition ◽

Submucous Fibrosis

ABSTRACT Oral submucous fibrosis (OSMF) is an established precancerous condition with increased prevalence in the Indian subcontinent. The treatment of OSMF is a challenging task for a clinician. Different authors have suggested variety of treatment modalities and have claimed success rates; still there is no universally acceptable protocol for the management of OSMF. In our case, transaction of bands was done by contact diode lasers (12 watt) under local anesthesia and it offered good results. Diode lasers offered excellent results and had many advantages over conventional surgical treatment. How to cite this article Soni A, Sharma S, Chitlangia P, Amit, Agarwal P. The Use of Diode Laser in Treatment of Oral Submucous Fibrosis. J Mahatma Gandhi Univ Med Sci Tech 2016;1(2):79-81.

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Quality of Life in Oral Submucous Fibrosis- A Case Report with a Literature Review

The Open Dentistry Journal ◽

10.2174/1874210602115010004 ◽

2021 ◽

Vol 15 (1) ◽

pp. 4-10

Author(s):

Shishir Ram Shetty ◽

Sesha Reddy ◽

Pooja Narain Adtani ◽

Raghavendra Shetty ◽

Ashwin Lakshminarayanan ◽

...

Keyword(s):

Quality Of Life ◽

Case Report ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Specific Questionnaire ◽

Spicy Food ◽

Potentially Malignant ◽

Submucous Fibrosis ◽

Published Research

Introduction: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder commonly found in the Southeast Asian region, classically characterized through restricted mouth opening and burning sensation in the mouth on consuming spicy food. The etiopathogenesis and treatment aspects of OSMF have been extensively researched and reviewed. However, the effect of this condition on the Quality of Life (QoL) of patients has not gained much consideration. The aim of our case report is to highlight the importance of evaluating the QoL in an OSMF patient by using discipline-specific questionnaire and also to present to the readers a review of the recently published research articles on the application of QoL questionnaires in OSMF patients. Results: It was observed that most of the researchers used generic and discipline-specific questionnaire for evaluating the quality of life in OSMF patients. Conclusion: Evaluation of QoL is recommended during the treatment of OSMF patients. There is a need to develop and employ more of disease-specific QoL instruments for OSMF patients.

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CLINICAL ASSESSMENT OF OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS IN PATIENTS FROM PATNA DENTAL COLLEGE & HOSPITAL

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i10.765 ◽

2019 ◽

Vol 3 (10) ◽

Author(s):

Dr. Tanoj Kumar ◽

Anurag Rai ◽

Dr. Minti Kumari ◽

Dr. Shweta Rai ◽

Dr. Avanindra Kumar ◽

...

Keyword(s):

Oral Mucosa ◽

Clinical Assessment ◽

Histopathological Examination ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Oral Pathology ◽

Areca Nut ◽

College Hospital ◽

Medical College ◽

Submucous Fibrosis

Oral submucous fibrosis is a chronic progressive scarring disease of oral cavity and oropharynx characterized by epithelial atrophy and juxta epithelial inflammatory reaction with progressive fibrosis of the lamina propria and deeper connective tissue. The resulting stiffness of the oral mucosa then causes a progressive decrease in mouth opening. Hence based on above findings the present study was planned for Clinical Assessment of Occurrence of Oral Submucous Fibrosis in Patients from Patna Medical College & Hospital. The present study was planned in Department of Oral Pathology, Patna Dental College & Hospital, Patna. Total 50 cases of the patient diagnosed with the Oral Sub mucous Fibrosis (OSMF) were evaluated in the present study. History, examination and investigation of patients were done in detail as per predesigned proforma. Histopathological examination of biopsy tissue from oral mucosa was done in patients who had taken pre-therapy and post-therapy (if and when required). X-ray of temporomandibular joint was requested (whenever needed). OSMF is a commonly occurring and widely spread premalignant condition increasingly affecting the youth. The occurrence of OSMF in gutkha chewers is far faster and more severe as compared in other forms of areca nut products chewers. The easy availability and promotions of these areca nut products especially gutkha and pan masala outside the schools colleges and social places has impacted younger population in India which has led to the increased occurrence of OSMF. Keywords: Oral Submucous Fibrosis, OSFM, gutkha, pan masala, etc.

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Application of injection Kenacort, intradermal route in oral submucous fibrosis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200037 ◽

2020 ◽

Vol 6 (2) ◽

pp. 316

Author(s):

Manjunath K. ◽

Amardeep Singh ◽

Manjunatha Rao S. V.

Keyword(s):

Soft Tissues ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Cost Effective ◽

Intradermal Injection ◽

Research Centre ◽

P Value ◽

Medical College ◽

History Of ◽

Submucous Fibrosis

Background: Oral submucous fibrosis is a potentially pre-malignant disease, that results in progressive juxta-epithelial fibrosis of oral soft tissues, resulting in increased loss of tissue mobility, marked rigidity and inability to open the mouth. Actual treatment includes iron, multi vitamins, lycopene, pentoxifyline, steroid injections and human placental extracts. Currently available treatment with intradermal injection of Kenacort with hyaluronidase is effective to some extent.Methods: This study was conducted at Basaveshwara Medical College and Hospital, Research Centre, Chitradurga, Karnataka, in the Otorhinolaryngology Department from February 2019 to August 2019 for 6 months duration. A total of 40 patients were included in this study. Mouth opening was recorded from baseline to 6 weeks. Cases were followed up for 6 months thereafter. Patients with positive history of chewing of betel-nuts, pan, gutkha and age from 18-50 years males and females were included in this study. Patients undergoing any surgery, allergic conditions, age more than 50 years were excluded. Mouth opening was assessed by objective type and subjective type.Results: There was significant increase in mouth opening in patients after administration of intra-dermal Kenacort injection and oral lycopene. The results were statistically significant and patients responded better and p value <0.001.Conclusions: Management of moderate oral submucous fibrosis should include counselling of patients along with oral lycopene with intradermal injection of Kenacort with hyaluronidase, is highly efficacious and cost- effective in improving the mouth opening and reducing other symptoms in patients with OSMF, whereas advanced stages should be treated surgically.

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