Oral Submucous Fibrosis
Etiology: Associated with an increased risk of developing this condition, Areca nut or betel nut chewing, genetic predisposition and genetic mutation, and nutritional deficiencies.
Epidemiology: Most found in India, Southeast, Asian countries, and Pacific Island nations.
Pathogenesis: Develop in people who chew Areca nut, usually betel quid, which is a form of topical tobacco mixed with slaked slime and Areca nuts.
Perioral and intraoral characteristics: First stage shows generalized stomatitis that manifests as erythematous mucosal tissues that develop numerous vesicles and ulcers. Second stage, or fibrosis stage, is characterized by the progressive accumulation of collagen fibers in the mucosal tissues. Decreased flexibility of the tongue, soft palate, and uvula.
Distinguishing characteristics: Extensive dark staining of their teeth.
Significant microscopic features: Early stages show edema, large fibroblasts, and inflammatory infiltrates. More advanced show dense bundles of collagen, decreased vascularity, and no edema.
Dental implications: Patients who chew betel nut should be encouraged to stop, and have regular examinations.
Differential diagnosis: May present similar to scleroderma.
Treatment and prognosis: No effective treatment, process is irreversible. Patient should be advised to stop chewing betel nut. Steroid injections may slow progression.