What is Oral Submucous Fibrosis?

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

When oral submucous fibrosis is detected in its early stages, ceasing to consume the irritating agent, such as the areca nut used in betel quids 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, oral submucous fibrosis symptoms 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 the mouth's range of motion.

Other treatments for oral submucous fibrosis include a course of hydrocortisone injected into the mucous 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. Human chorionic gonadtrophine (HCG) injections in two to three doses per week over three to four weeks have also been effective in treating oral submucous fibrosis. Surgery is indicated in cases where the space between the patient's teeth has been reduced to 2 cm or less.

In conjunction with the treatments mentioned above, there are several 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 decrease the viscosity of the body's blood, is sometimes prescribed to improve blood supply to the affected tissues. Patients are also usually counseled to avoid hot drinks such as coffee and tea, as well as potentially irritating fluids, such as alcoholic beverages. The physician will also usually recommend the patient avoid consumption of spicy foods and other substances that tend to irritate the mouth's mucous membranes.