National Journal of Maxillofacial Surgery

EDITORIAL
Year
: 2021  |  Volume : 12  |  Issue : 3  |  Page : 295--296

Early diagnosis of oral submucous fibrosis is a boon in the prevention of oral cancer


US Pal 
 Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King Georges Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
U S Pal
Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King Georges Medical University, Lucknow, Uttar Pradesh
India




How to cite this article:
Pal U S. Early diagnosis of oral submucous fibrosis is a boon in the prevention of oral cancer.Natl J Maxillofac Surg 2021;12:295-296


How to cite this URL:
Pal U S. Early diagnosis of oral submucous fibrosis is a boon in the prevention of oral cancer. Natl J Maxillofac Surg [serial online] 2021 [cited 2022 Jan 20 ];12:295-296
Available from: https://www.njms.in/text.asp?2021/12/3/295/332327


Full Text



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Oral submucous fibrosis (OSMF) is a slowly progressive potentially malignant disorder can result in complete closure of mouth and may change into the oral cancer. Public is more aware regarding the health hazard of alcohol and narcotics, but awareness about the tobacco and areca nut chewing is comparatively low. Tobacco and gutka are also having a lot of publicity with the warning in short, that is a great tragedy. Prevalence of OSMF varies from 0.2% to 0.5% in India, with a high percentage being found in Southern part of our country. A malignant transformation rate is 2.3% to 7.6%, genomic instability along with keratinocyte phenotype, play a significant role in the malignant transformation.[1] We can put scleroderma in the differential diagnosis of this disease. An etiology of OSMF is closely associated with areca nut chewing, nutritional deficiency, and genetic. Habit of areca nut chewing (gutka) and smoking are not less injurious than narcotics and alcohol so our country needs more sensitization and public health measures for proper awareness and early diagnosis of OSMF along with cessation of habits.

Management of OSMF includes medicinal management up to 25 mm mouth opening and <25 mm mouth opening needs surgical treatment. A medical treatment may be the administration of antioxidants, anti-inflammatory, and proteolytic drugs (triamcinolone and hyaluronidase). A submucosal injection and topical application of triamcinolone may also be advised but along with these things, habit cessation is of prime importance. A surgical treatment includes resection of fibrous bands and interposition of different flaps such as palatal flap, tongue flap, nasolabial flap, platysma flap, buccal pad of fat, dermis fat, radial forearm free flap, split skin graft, etc.[2]

Apart from surgical and medical treatment, physiotherapy is also in a routine practice but there is no scientific evidence that physiotherapy that is forceful mouth opening improves the result. In fact, forceful mouth opening will lead to microbleeding followed by inflammation and healing with scar which in turn leads to more fibrosis. Hence, excessive forceful mouth opening should be avoided. As per the ancient system of medicine (Ayurvedic), OSMF can be considered as Anukta Vyadhi, some other descriptions related to OSMF are Krichchhen Vivrinoti Mukham, Mukhadaha, Tikshna Asaha, Mukhasosha, Arasagyata, Alparasagyata and vranavastu, and Durudha Vrana.[3]

Executive summary may be following:

Awareness programs for masses with the use of social media and screening campsEarly diagnosis of OSMF shall lead to better prognosis and may prevent the malignant transformationRegistry of OSMFReligious follow-up for at least 5 years after treatmentOnly modest forceful mouth opening should be institutedImpacted molars should also be taken care specially if there is pericoronitisHabit cessation training should be included in the dental education.

References

1Ramanjaneyulu P, Prabhakara Rao BS. Submucous fibrosis: New treatment. J Indian Dent Assoc 1980;52:379-80.
2Nigam NK, Aravinda K, Dhillon M, Gupta S, Reddy S, Srinivas Raju M. Prevalence of oral submucous fibrosis among habitual gutkha and areca nut chewers in Moradabad district. J Oral Biol Craniofac Res 2014;4:8-13.
3Pindborg JJ, Mehta FS, Gupta PC, Daftary DK. Prevalence of oral submucous fibrosis among 50,915 Indian villagers. Br J Cancer 1968;22:646-54.