Clinical and Functional Staging of Oral Submucous Fibrosis for the Establishment of Management Protocol A Preliminary Study

Abstract

Oral submucous fibrosis is a debilitating pre-cancerous condition, which involve the oral cavity including pharynx. It is predominantly seen in people in South-Asian countries or in South-Asian immigrants to other parts of the world. Various factors have been implicated in the development of oral submucous fibrosis, the most common of which is chewing arecanut. Oral submucous fibrosis is diagnosed on certain clinical criteria and further confirm by histopathology.

The main objective of this study was to identify the relevant clinical features and staging of oral submucous fibrosis. Staging of submucous fibrosis would enable the formulation of a management protocol.

The study sample consisted of 30 patients with oral submucous fibrosis who visited the Oral Medicine clinic, Faculty of Dental Sciences, University ofPeradeniya from January 1998 to August 2001. Oral submucous fibrosis was diagnosed on clinical criteria including burning sensation in mouth, depapillation of tongue, presence of fibrous bands in mouth, restriction of tongue protrusion and limitation in mouth opening. Limitation of mouth opening was recorded in millimeters (mm) between the incisal edges of corresponding upper and lower central incisors.

According to these criteria patients were categorized into three clinical stages (stage I, IT, III). 33.3%, 40010 and 26.6% of patients were found in clinical stages I, II and III respectively. Functional staging was done according to the amount of mouth opening. Patients with mouth opening ≥ 30mm were categorized into functional stage 1, 19mm-29mm into functional stage II, ≤ 20mm into functional stageIII.22 (73%), 7 (23.2%) and 1(3.3%) were found in each functional stage respectively.