Oral submucous fibrosis--a potentially malignant condition of growing concern

Oral submucous fibrosis (OSF) is a premalignant condition that primarily affects the oral cavity. The clinical hallmark of this disease is the development of progressive trismus. The latter is a direct consequence of loss of the normal fibro-elasticity of the oral mucosa and replacement of the fibromuscular connective tissue by the deposition of dense collagen. This change in the oral mucosa is aetiologically linked to the areca nut chewing habit where the development of OSF results from the interaction of the mucosa with the chemical constituents of areca. Areca nuts are used as a masticatory substance either alone, in a self-prepared quid or in various commercial preparations known as paan masala and gutka. The habitual usage of these products is rapidly increasing and oral health professionals globally are likely to encounter patients with this disease. The potentially malignant nature of OSF is well documented and habitual areca nut chewing even in the absence of tobacco is an independent risk factor for oral cancer. Public health education against the areca nut chewing habit is essential to eradicate the deleterious effects of this habit on oral health.