Context:Areca nut is chewed by itself and in various scented preparations. Areca nut chewing is widely practiced in many parts of Asia, including India. Users often consider it harmless and report a sense of well-being, but evidence has shown that it is far from harmless and can have multiple oral health implications such as oral submucosal fibrosis posing difficulty in opening mouth and carcinogenesis. Studies in India have reported increasing prevalence of this habit among schoolgoing children. The objectives of the study were to find the effect of areca nut chewing on mouth opening, compare it with the children not having this habit, and to find correlation between maximal mouth opening (MMO) and months of areca nut chewing.Aims:The aim of this study is to find the effect of areca nut chewing on MMO in schoolgoing children in Ahmedabad.Settings and Design:An observational analytical study was conducted across various schools of Ahmedabad.Subjects and Methods:A total of eighty male students of 12–14-year-old were included in the study. Group A included children having the habit of eating areca nut for 6 months or more, and Group B had children who did not have the habit of areca nut chewing. Children who had just started eating for <6 months were excluded from the study. MMO was calculated as distance from the edge of the upper incisor teeth to the edge of the lower incisor teeth using a calibrated fiber ruler.Statistical Analysis Used:Statistical analysis was performed by SPSS software version 20.0, with level of significance set at 5%.Results:Mean and standard deviation of MMO for Group A was 3.69 ± 0.5 cm and for Group B was 4.46 ± 0.4 cm. Statistically significant difference was found using Mann–Whitney U-test with U = 239.500 and P = 0.0001. Pearson's coefficient r = −0.623 and P = 0.0001 showed moderate correlation between months of chewing and MMO. The mean duration of chewing was found to be 1.5 years.Conclusion:There is difference in MMO between children chewing areca nut and not chewing it with a moderate correlation between months of eating areca nut and MMO.

Introduction: Oral Sub Mucous Fibrosis (OSMF) is a chronic, complex potential potent pre-cancerous condition characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the sub mucosa (lamina propria and deeper connective tissues). As the disease progresses it leads to disorders of the temporo mandibular joint (TMJ) causing various combinations of limitation of movement of the jaw, pain, locking or clicking sounds and difficulty in opening mouth ,usually treated by maxillofacial surgeries or medical approaches. Objective: To study the effect of TMJ mobilization on maximal mouth opening in subjects with OSMF. Method: A quasi-experimental study was conducted at college of physiotherapy, Ahmadabad. Twelve participants of OSMF with history of tobacco chewing since last 6 months and willing to participate in the study were included and those who underwent any surgery for OSMF or any injections for pain relief were excluded from the study. The subjects were divided into two groups (A and B). Group A (control group) was given home exercise programme in form of stick exercises. Group B (experimental group) was given TMJ mobilization and stick exercises. Both the groups received treatment for 4 weeks. Maximal mouth opening (MMO) was measured. For MMO, distance from edge of upper incisor teeth to edge of lower incisor teeth was measured using calibrated fibre ruler on first day and after four weeks of intervention. Level of significance was kept at 5%.Results: Pre intervention MMO in group A was 1.9+0.81 and in group B was1.7+0.79. Post intervention MMO in group A was 3.13+0.58 and in group B was 4.43+0.71. Within group analysis using Wilcoxon test showed statistically significant difference in both the groups A and B (Z=2.37, p=0.028and Z=2.21, p=0.018 respectively). Between group analysis using Mann Whitney U test showed statistically significant difference between both group (U=0.2, p=0.01).Conclusion: Both Temporo mandibular joint mobilization and home exercise programme are beneficial but TM joint mobilization has more effect on maximal mouth opening than home exercise program in subjects with Oral sub mucosal fibrosis.