Submucous Fibrosis in Young Adults – Risk Factors and Symptoms

Submucous Fibrosis in Young Adults – Risk Factors and Symptoms

Question 10. Write a short note on submucous fibrosis.
Answer:

Submucous fibrosis

OSMF is defined as “An insidious chronic disease affecting any part of the oral cavity and sometime pharynx. Although occasionally preceded by and/or associated with vesicle formation, it is always associated with juxtaepithelial inflammatory reaction followed by fire-elastic changes in lamina propria, with epithelial atrophy leading to stiffness of oral mucosa and causing trismus and inability to eat.” Pindborg (1966).

“Understanding submucous fibrosis: Causes and symptoms”

Submucous fibrosis Etiology

The OSMF is caused due to:

• Excessive consumption of red chilies.
• Excessive “areca nut” chewing.
• Nutritive deficiency
• Immunological fractures
• Genetic factors
• Protracted tobacco use
• Patient with deficiency of micronutrients.

Oral submucous fibrosis

“Techniques for managing submucous fibrosis symptoms”

“Importance of early detection of submucous fibrosis”

Submucous fibrosis Clinical Features

• It is caused during 20 to 40 years of age.
• Females are affected more than males.
• In OSMF fibrotic changes are frequently seen in the buccal mucosa, retromolar area, uvula, tongue, etc.
• Initially patient complains of a burning sensation in the mouth, particularly during taking hot and spicy foods.

“Role of surgical intervention in treating submucous fibrosis”

• There can be excessive salivation, decreased salivation, and defective gustatory sensation.
• In the initial phase of the disease palpation of mucosa elicits a “wet leathery” feeling.
• In the advanced stage, the oral mucosa loses its resilience and becomes blanched and stifled and thereby causing trismus.
• Palpation of mucosa often reveals vertical fibrous bands.

Risk factors for oral submucous fibrosis

Submucous fibrosis Histopathology

Microscopically OSMF reveals the following features:

• Overlying hyper keratinized, atrophic epithelium often shows flattening and shortening of rete pegs.
• There can be variable degrees of cellular atypia or epithelial dysplasia.
• In OSMF dysplastic changes are found in epithelium which include nuclear pleomorphism, severe intercellular edema, etc.

“Impact of betel nut consumption on oral health”

• The stromal blood vessels are dilated and congested and there can be areas of hemorrhage.
• The underlying connective tissue stroma in an advanced stage of the disease shows homogenization and hyalinization of collagen fibers.
• Decreased number of fibroblastic cells and narrowing of blood vessels due to perivascular fibrosis are present.
• There can be the presence of signet cells in some cases.

What causes submucous fibrosis

“Common causes of submucous fibrosis explained”

Submucous fibrosis Treatment

• Stop areca nut and tobacco chewing strictly.
• Definitive treatment of OSMF includes intralesional injection of collagenase, corticosteroids, fibrinolysin, etc.
• Systemic administration of steroids in severe cases.