Oral submucous fibrosis: what is it?

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Oral submucous fibrosis is a condition that causes inflammation and fibrous growths in the mouth, leading to jaw paralysis. It is linked to the consumption of betel quid and spicy foods. Treatment options include stopping the irritant, injections of bone marrow stem cells, hydrocortisone, HCG, and surgery. Patients are advised to avoid hot beverages, alcohol, and spicy foods.

Oral submucous fibrosis (OSF) is a medical condition that affects the mouth causing inflammation of the mucous membranes and the formation of fibrous growths on the walls of the mouth. It causes progressive immobilization of the jaw as the disease progresses, resulting in total paralysis of the jaw over time. Described in 1952 by J. Schwartz who studied a group of Asian women living in Kenya, the condition is linked to oral cancers and the practice of chewing betel quid (areca nut). The disease is also associated with the consumption of spicy foods such as red chili peppers, dietary deficiencies, extreme climates, and immunological conditions.

When oral submucosal fibrosis is detected in its early stages, stopping consuming the irritant, such as the areca nut used in betel quid or chewing tobacco, will often resolve the problem. Most patients, however, seek medical attention when the disease has become moderate to severe. At this stage, symptoms of oral submucous fibrosis are not reversible, and treatment is symptomatic, focusing on restoring some degree of mouth movement in response to the paralysis of the jaw. Treatments using injections of bone marrow stem cells have been effective in improving range of motion in the mouth.

Other treatments for oral submucous fibrosis include a course of hydrocortisone injected into the mucosal tissue on a daily basis for two to three weeks, depending on the severity of the disease. Chewable hydrocortisone pellets are also sometimes prescribed and chewed every three to four hours for three to four weeks. Injections of human chorionic gonadtrophin (HCG) in two to three doses per week for three to four weeks have also been effective in treating oral submucosal fibrosis. Surgery is indicated in cases where the patient’s tooth gap has been narrowed to 2 cm or less.

In combination with the treatments mentioned above, there are many other considerations that can be taken by the patient to potentially improve or delay the symptoms of oral submucous fibrosis. Pentoxifylline, a drug that works to reduce the viscosity of the body’s blood, is sometimes prescribed to improve blood supply to affected tissues. Patients are usually advised to avoid hot beverages such as coffee and tea, as well as potentially irritating liquids, such as alcoholic beverages. The doctor also usually advises the patient to avoid consuming spicy foods and other substances that tend to irritate the mucous membranes in the mouth.




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