Evaluation of demographic and clinical characteristics of oral submucous fibrosis in a group of Sri Lankan patients – a retrospective cohort study

Abstract

Oral submucous fibrosis (OSF) is a well-established oral potentially malignant disorder (OPMD) that affects the South Asian countries including Sri Lanka where the traditional habit of areca nut chewing prevails. The aim of this study was to evaluate the demographic and clinical characteristics of OSF among patients presented to the Faculty of Dental Sciences, University of Peradeniya. A retrospective cohort of 503 patients, diagnosed with OSF, followed up in the Oral Medicine clinic, for the past 22 years were included in the study. Patients‘ age ranging from 3 - 81 years (394 males (78.3%) and 109 females (21.6%); mean age, 43.38 years) with the diagnosis of OSF presented to Oral Medicine clinic. The main complaint of the patients presented was burning sensation (45.1). Fifty six patients complained either of an ulcer or a white/red patch. Majority, 69.8% had the habit of betel chewing only, while 14 had chewing areca nut alone as their risk factor and 18.1% had the synergistic habit of betel chewing and smoking. 65.4 % had the involvement of the buccal mucosa with the presence of fibrous bands on the initial visit with 28.4% demonstrating restricted tongue movements. The commonest abnormality observed on the tongue was depapillation (55.7%) and de- pigmentation, an early feature noted in 27.2%. A total of 463 patients had undergone a histopathological investigation and almost 50% of those were devoid of any dysplastic lesions. According to the grading system by Kerr et al. (2011), 39% of cases were at Grade 4B, that is OSF with any grade of dysplasia in the biopsy at the initial presentation and only 16% presented with mild disease (Grade 1). The clinical characteristics of OSF patients may differ due to variations in risk habits practiced.