Areca Nut: A Case Study

The consumption of areca nut or betel nut in India has been practiced from a long time. Previously it was being used in the few forms but in the present scenario a large number of marketed products are available commercially. Some of these products which are very high in demand are Khaini, Gutkha, Pan with tobacco, Pan masala, Kharra, Toothpastes, dry snuff etc.1 In 1952, Schwartz2 described five Indian women from Kenya with a condition of the oral mucosa including the palate and pillars of the fauces, which he called "atrophia idiopathica (tropica) mucosae oris". Later it was termed oral submucous fibrosis (OSMF)3; other names are "diffuse oral submucous fibrosis", "idiopathic scleroderma of the mouth", "idiopathic palatal fibrosis", "sclerosing stomatitis" and "juxta-epithelial fibrosis.4,5 Oral submucous fibrosis is a chronic insidious disease and a well

Score 9: Mouth opening is 05 to 08 mm
Score 10: Mouth opening is 0 to 04 mm.
Nagesh and Bailoor (1993) based on diagnosis :
• Stage I early OSMF: Mild blanching, no restriction in mouth opening (normal distance between central incisor tips: Males 35 to 45 mm, females 30 to 42 mm), no restriction tongue protrusion.
•Stage II moderate OSMF: Moderate to severe blanching, mouth opening reduced by 33%, cheek flexibility also demonstrably reduced, burning sensation also in absence of stimuli, palpable bands felt. Lymphadenopathy either unilateral or bilateral and demonstrable anemia on hematological examination.
• Stage III severe OSMF: Burning sensation is very severe patient unable to do day-to-day work, more than 66% reduction in the mouth opening, cheek flexibility and tongue protrusion. Tongue may appear fixed. Ulcerative lesions may appear on the cheek, thick palpable bands and lymphadenopathy bilaterally evident.

Lai Dr (1995) divided OSMF based on the inter-incisal distance as follows:
• Group A: >35 mm
• Group B: Between 30 and 35 mm
• Group C: Between 20 and 30