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Oral Submucous Fibrosis (OSMF) - Etiology and Treatment

18 September, 2020 Shivya Soni

ORAL SUBMUCOUS FIBROSIS (OSMF) is defined as a debilitating disease of the oral cavity characterized by a precancerous condition that is characterized by inflammation and there is progressive fibrosis of the submucosal. It is occasionally preceded by, or associated with, the formation of vesicles

Oral submucous fibrosis leads to marked rigidity associated with a marked inability to open the mouth. The buccal mucous membrane is that the most typically concerned oral site, The buccal mucosa is the most commonly involved site including the others and pharynx. It is a scarring disease mostly involving the pharynx and upper part of the esophagus.

What is the Cause of Oral Submucous Fibrosis?

Arecanut, however, is the main reason behind the premalignant condition.


Folks that chew or consume it in numerous forms like gutkha, mawa, pan masala, Piper betel daft ar seen with these premalignant conditions. The explanation behind is that the presence of Arecoline and Arecaidine nitrosation causes desoxyribonucleic acid alkylation with the proliferation of fibroblasts and elevated scleroprotein synthesis. Conjointly gift, phenol gift in betel nut reduces scleroprotein degradation by inhibiting enzymes.

Nutritional Deficiency

Deficiency of iron (anemia), vitamin B complex, minerals, and deficiency disease are promoting factors that disturb the repair method of the inflamed oral mucous membrane, so results in crazed healing. 

Supplements are prescribed by doctors in case of nutrients deficiency which can be bought online from the best online medical app Delhi

Genetic Cause

A genetic basis is taken into account to be the cause wherever there's no history of arecanut consumption.

What is the Clinical Presentation of Pre Malignant Condition? 

The symptoms and signs of OSMF are because of inflammation and, primarily, fibrosis.

the foremost common initial symptoms and signs are a burning sensation, dry mouth, blanching oral mucous membrane, and ulceration.

There are 3 stages within which the symptoms appear:

STAGE 1: inflammation as well as vesicles, erythema, membrane ulceration, membrane pigmentation.

It happens in the early stages of the condition.

STAGE 2: Blanching of mouth gap, gruff voice, reduction in mouth gap, the issue in speaking and swallowing, bud-like a flap, and stiff tongue.

STAGE 3: it's the severe stage because of the involvement of the Eustachian tube and tubular cavity, the issue in speech and intake worsens and the mouth gap is reduced to a nice extent.

Pain persists and it's the advance stage.

What is the Treatment of Osmf? 

OSMF progresses over time and its management depends upon clinical features and stage of the condition.

Some conservative and surgical interventions might lead to improvement. The most vital side of medical treatment is that the cease of the habit of intake betel quid, areca nut, alternative native irritants, spicy and hot food, alcohol, and smoking. The foremost common mode of medical treatment had been the utilization of steroids in its numerous forms.

Alternative strategies embody injection of placental extract, use of an enzyme, collagenase, enzyme and enzyme, and intralesional Interferon-γ.

At the early stages, stopping the habit and organic process supplements are done.

At moderate stages, conservative treatment like intralesional injections alongside medical treatment is provided.

At advanced stages, surgical interventions are required.

Supplement Care

Diet made in iron, vitamins, and minerals ought to be suggested to patients with OSMF and these supplements might relieve inflammation, inflammation of the tongue, and disorder in OSMF patients.


Carotenoids (lycopene) induce stimulation of the system or protest in neoplasm cells.

carotenoid inhibits viscus pathology genes in LEC rats and conjointly exerts an analogous inhibition on the abnormal fibroblasts in OSMF.

Steroids → reduction of proliferation of fibroblasts → variety of scleroprotein fibers decreases.

Steroids unharness cellular proteases enzymes in living thing compartment in connective tissues scleroprotein activation of scleroprotein and zymogen → bodily function of insoluble scleroprotein → breakdown stimulation.

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The incidence is rising; there has been no important improvement in management, nor reduction in its high malignant transformation rate. Better integration of medical and dental services, particularly in developing countries, might scale back patients’ suffering and improve their life quality. All health care professions should work along with public education.