Oral Submucous Fibrosis in Pediatric Patients: A Systematic Review and Protocol for Management

Abstract

Aim. To conduct a systematic review evaluating the cases of oral submucous fibrosis in pediatric patients. Material and Method. Systematic review was conducted using PRISMA guidelines. The article focused on oral submucous fibrosis in pediatric patients were included. A total of five manuscripts were included in our systematic review. The prevalence of OSMF in pediatric patients, gender distribution, causes, and clinical presentation were reviewed. Results. On systematically reviewing, a total of 10 cases of OSMF in pediatric patients were found. The youngest patient reported to be diagnosed with OSMF was of 2.5 years of age. Female preponderance was noticed. All the patients had the habit of areca nut chewing which subsequently led to fibrosis. Conclusion. Such a rapid increase in the rate of OSMF among pediatric population is a potential danger to the society. The habit of areca nut chewing is the major cause for this dreadful condition. Lack of health consciousness and low level of education are the major factors for initiation of this habit among children. Therefore it is imperative for the parents and school as well as government authorities to take serious actions.

No age predilection for a disease like OSMF. A case report of 5-year-old child

“…Cellular elements and blood vessels might be reduced. 8 There are many evidences of reported cases across the globe in pediatric age. Hayes (1985) reported first Case of OSMF in a 4-year-old girl.…”

Oral Submucous Fibrosis: A Review on Biomarkers, Pathogenic Mechanisms, and Treatments

“…Unfortunately, the commercially modified areca nut is cheap, sweet, and readily available in India. Moreover, the low oral health literacy of parents and children furthers the risk of addiction in young children, which consequently increases the burden of OSF [ 39 , 40 ]. Arecoline is the major compound in betel nut that initiates the OSF process [ 41 , 42 , 43 ].…”

“…The main components of areca nut contain 31.1% phenols, 18.7% polysaccharides, 14% fat, 10.8% fiber, and 0.5% alkaloids [ 103 ]. Arecoline is the main alkaloid that causes the pathogenesis of the OSF [ 38 , 39 , 40 ]. Arecoline stimulates the fibroblast cells to express growth factors and cytokines that enhance the collagen deposition and repress the collagen degradation.…”

Oral submucous fibrosis in children: an alarming condition and challenges in management

“…This premalignant condition predominantly occurs in the Indian subcontinent with a prevalence rate of 0.5% and a female preponderance with a ratio of 3:1. 1 OSF may transform into oral malignancy, specifically oral squamous cell carcinoma with a malignant transformation rate of 7.6% as highlighted in the study conducted by Murti et al . 2 Other studies in the literature suggests that the malignant transformation rate ranges from 7% to 13%.…”

“…The corrective measures include the medicinal treatment with agents like lycopene, micronutrients, steroids, chymotrypsin, hyaluronidase, turmeric and placental extracts along with oral physiotherapy. 1 Extensive cases even require surgical treatment.…”