More and more people these days are complaining that they're increasingly unable to open their mouths. Almost all of them complain of a soreness of the mouth and constant burning in the oral cavity. Some have a nasal voice and find they can't blowout the cheeks and extend the tongue. Others complain of difficulty in swallowing. All these patients suffer from oral submucous fibrosis(SMF).

 

Individuals have a history of chewing pan masala, tobacco or betel nut with lime (gutkha), either singly or in combination. When chewed, these substances damage the normal soft and supple lining (mucosa) of the oral cavity. A dense fibrous tissue is deposited in the submucosal layer of the soft palate and cheek, causing disabling symptoms like trismus.

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Gutkha contains betel nuts, tobacco, lime, catechu and permitted spices and flavours. The first four sustances damage the sensitive mucosa, causing constant irritation and mi- crotrauma to the mucosa. Chemicals present act as a toxin. The phenol in the betel nut, with its caustic burning effect,destroys the mucosa ,causing oral ulcers. The betel nut also contains tannins, which act as astringents, precipitating protein and damaging the mucosa.