Association Between Grading of Oral Submucous Fibrosis With Frequency and Consumption of Areca Nut and Its Derivatives in a Wide Age Group: A Multi-centric Cross Sectional Study From Karachi, Pakistan

Abstract

Background:Oral submucous fibrosis (OSMF) is a chronic, premalignant condition of the oral mucosa and one of the commonest potentially malignant disorders amongst the Asian population. The objective of this study was to investigate the association of etiologic factors with: age, frequency, duration of consumption of areca nut and its derivatives, and the severity of clinical manifestations.Methods:A cross-sectional, multi centric study was conducted over 8 years on clinically diagnosed OSMF cases (n = 765) from both public and private tertiary care centers. Sample size was determined by World Health Organization sample size calculator. Consumption of areca nut in different forms, frequency of daily usage, years of chewing, degree of mouth opening and duration of the condition were recorded. Level of significance was kept at P ≤ 0.05.Results:A total of 765 patients of OSMF were examined, of whom 396 (51.8%) were male and 369 (48.2%) female with a mean age of 29.17 years. Mild OSMF was seen in 61 cases (8.0%), moderate OSMF in 353 (46.1%) and severe OSMF in 417 (54.5%) subjects. Areca nut and other derivatives were most frequently consumed and showed significant risk in the severity of OSMF (P ≤ 0.0001). Age of the sample and duration of chewing years were also significant (P = 0.012).Conclusions:The relative risk of OSMF increased with duration and frequency of areca nut consumption especially from an early age of onset.

Oral submucous fibrosis: Correlation of clinical grading to various habit factors

“…In this study, no significant deviation was observed in the distribution of the participants according to age and gender based on the OSMF grading. This finding was in accordance to the study conducted by Hosein et al .,[8] where they found similar findings. The clinical and functional grading of OSMF was adopted from Haider et al .…”

The pharmacology, toxicology and potential applications of arecoline: a review

“…In fact, current investigations indicated that the most serious side-effects of arecoline are the oral toxicities Chen et al 2014). Oral submucous fibrosis (OSF) is a potentially malignant disease predominantly seen in people of Asian; epidemiological surveys provide valid evidence that chewing AN can lead to OSF, and arecoline is the main etiological factor (Prabhu et al 2014;Hosein et al 2015). It could interfere with the molecular processes of deposition and/or degradation of extracellular matrix (ECM) molecules, such as collagen, causing imbalance in the normal process (Utsunomiya et al 2005;Tilakaratne et al 2006;Arakeri & Brennan 2013).…”

Regulation of Jun and Fos AP-1 transcription factors by JNK MAPKs signaling cascade in areca nut extract treated KB cells

“…Chronic usage of areca nut will lead to infectious lesions that lead to various oral disorders and could transform to oral carcinogenesis, collectively called as orally potential malignant disorders (OPMDs) [ 14 , 15 ]. Areca alkaloid arecoline is a significant etiological factor that is responsible to cause cytotoxicity and genotoxicity in various cell system [ 16 , 17 ]. Various active constituents of areca nut extract have been reported to cause decreased viability with increased generation of free radicals [ 18 ].…”