Oral submucous fibrosis is a chronic condition that is progressive and irreversible to a large extent. In technical terms, it is known as collagen metabolic disorder in the mouth that is largely caused due to chewing the areca nut and its variants (gutkha, kiwam, Zarda, and pan masala).

Symptoms and clinical features

The initial symptoms of oral submucous fibrosis may include a strong burning sensation in the mouth and at times, the formation of blisters. In addition, the mouth may start to dry up due to ulcers. In the later stages, the symptoms include :

  1. Difficulty in opening the mouth wide which affects swallowing and eating.
  2. The tongue is smooth and does not move easily
  3. Cheeks feel stiff and firm
  4. Lips feel rubbery

In complex cases, the fibrosis could affect the soft palate, esophagus, and the throat as well.


It goes without saying that the practice of chewing ‘paan’ and consuming tobacco should immediately stop to ensure the disease does not progress further. A regular examination may be necessary to assess the development of oral cancer. In addition, doctors will also keep a track of the extent of how much the mouth opens and keep a record of it to ensure the treatment is effective.

Typically, treatment includes corticosteroid injections to the fibrotic bands every 6-8 weeks. Moreover, nutritional supplements may also be used. For an advanced stage of the disease, surgery may be essential to ensure the mouth opens just enough and also to restore normal functions.

Who is likely to get oral submucous fibrosis?

In the Indian sub-continent it highly common to see individuals chewing betel nut or ‘paan’ and its aforementioned variants. Although predominant in adults, children also consume other sweetened versions of betel quid such as sweet supari, meetha pan, etc. However, oral submucous fibrosis is common amongst individuals who fall under the age group of 20-40 years of age. The occurrence of the condition is high as tobacco products are easily available without any restrictions.