It is a chronic disease affecting the oral cavity and pharynx causing stiffness of oral mucosa, difficulty in mouth eating, and inability to eat.

It is a chronic pre-cancerous condition commonly seen In tobacco chewers. This condition is most common in India and other Asian countries. In India, incidence of OSMF  is 0.3 to 0.6 %

Factors causing OSMF

• Tobacco-  paan masala, and ghutka have higher concentrations of areca nut. It acts as a chronic irritant.

Other causes

• Nutritional deficiency  (vitamin B complex )
• Lime which is used in betel nut causes damage to the oral mucosa.
• Immunological disorders.

Signs and symptoms

• Affects the older age group of around 30 to 40 years.
• Mainly seen on the buccal mucosa. (image), soft palate, tongue, uvula, gums, floor of mouth
• The most common feature is that the mucosa appears blanched and white because of reduced blood supply.
• Patients complain of a burning sensation in the mouth which aggrevates on spicy food.
• Dryness of mouth or increased salivation.
• Ulcerations
• In later stages, there is the formation of fibrous bands on the mucosa.
• The mucosa feels rough and irregular on touching.
• Stiffness of mouth and difficulty in eating and mouth opening.
• The papilla present on the tongue is lost leading to a smooth tongue.
• Lips become hard and leather.

• Uvula becomes short and shrunken and is sais to have a hockey stick appearance. (image)
• If left untreated it will lead to difficulty in protruding the tongue, difficulty in swallowing,
• This pain might get referred to the ears and also causes typical nasal voice.

Management

• Stop the habit
• Have a vitamin-rich diet
• Steroids like hydrocortisone injection or hydrocortisone tablet.
• Surgical procedure (removal of fibrous bands followed by flap )
• Laser therapy
• Cryosurgery (i.e destruction of local tissues by freezing them )
• Oral physiotherapy