Objective: To determine the frequency of oral submucous fibrosis in patients coming to dental OPD of a tertiary care hospital and to correlate the association of level of education among patients of oral submucous fibrosis.Methodology: A cross sectional study was conducted from January 2018 to December 2018 among patients coming to the dental OPD of a tertiary care hospital in Karachi. Convenience sampling was used to select patients of Oral Submucous Fibrosis and a structured questionnaire was used to collect data on level of education, age, gender and Habit. Result: A total of 4405 patients visited the OPD and 135 patients were diagnosed with OSMF based on clinical findings. Mean age of OSMF patients was 33.6 years with nearly half 47.7% having no formal education.43.2% were skilled workers followed by 34.8% housewives and 22% were professionals. Betel nut was the most common used habit 79.5% among OSMF patients. Significant association of betelnut (p-0.001) among females(94.5%) compared to males (68.8%) and significant association of gutka (p-0.004) among males(24.7%) than females (5.5%)was observed. No significant association of level of education with substance abuse was observed. Conclusion: The finding of high frequency of betel nut usage among housewives and gutka among skilled workers is alarm some. Our literacy level despite being very low is not the sole reason of increase of substance abuse rather even the educated ones are not at par with this habit.

Proliferative verrucous leukoplakia is one of the rare premalignant white lesions with highest conversion rate to malignancy. It grows gradually and irreversibly with multifocal presentation, exophytic and verrucous appearance. This lesion has been reported resistant to all therapeutic approaches including both non-surgical and surgical. Predisposing factors include female gender in the 6th decade of life. Proliferative verrucous leukoplakia has the highest tendency to neoplastic transformation and progression to oral squamous cell carcinoma and oral verrucous carcinoma in majority of the cases. The case of proliferative verrucous lesion clinically appearing benign presented here but on histopathology proven dysplasia in a patient with the history of smoking which he stopped six years back