Skip to main content
SpringerLink
Log in

Epidemiology of Oral Submucous Fibrosis: Prevalence and Trends

  • Chapter
  • First Online:
Oral Submucous Fibrosis

Part of the book series: Textbooks in Contemporary Dentistry ((TECD))

  • 177 Accesses

Abstract

This chapter outlines the findings of research studies undertaken across the world to determine the prevalence of OSF and to better understand the demographics, risk factors, and sociocultural factors that influence OSF development. Prevalence of OSF may vary depending on the definition used, the lifestyle of the population studied, and the clinical criteria used to detect OSF. The World Health Organization (WHO) reported more than five million OSF patients worldwide in 2002. In India, the prevalence of OSF is estimated to be between 0.2% and 2.3% in males and 1.2–4.6% in females, with the disease affecting a wide age range of 11–60 years. A marked variation in the prevalence data is noted depending on the geographic area, sample size, and sampling methods. Recent studies from India report a male preponderance as compared to females and gutkha followed by mawa chewing are found to be the common behaviours adopted at all initiation ages. An increasing trend in the prevalence of OSF is reported in many studies from India and Taiwan. Widespread commercialization of areca nut products and uptake in consumption among the youth are attributed to these rising trends.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Warnakulasuriya S, Johnson N, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36(10):575–80.

    Article  PubMed  Google Scholar 

  2. Rajalalitha P, Vali S. Molecular pathogenesis of oral submucous fibrosis—a collagen metabolic disorder. J Oral Pathol Med. 2005;34:321–8.

    Article  PubMed  Google Scholar 

  3. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Personal habits and indoor combustions. volume 100 E. A review of human carcinogens. IARC Monogr Eval Carcinog Risks Hum. 2012;100:1–538.

    PubMed Central  Google Scholar 

  4. Anon. Epidemiology is a science of high importance. Nat Commun. 2018;9:1703.

    Article  Google Scholar 

  5. Harder T. Some notes on critical appraisal of prevalence studies: Comment on: “The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence”. Int J Health Policy Manag. 2014;3:289–90.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gupta PC, Sinor PN, Bhonsle RB, Pawar VS, Mehta HC. Oral submucous fibrosis in India: a new epidemic? Natl Med J India. 1998;11:113–6.

    PubMed  Google Scholar 

  7. Rao NR, Villa A, More CB, Jayasinghe RD, Kerr AR, Johnson NW. Oral submucous fibrosis: a contemporary narrative review with a proposed inter-professional approach for an early diagnosis and clinical management. J Otolaryngol Head Neck Surg. 2020;49(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cox SC, Walker DM. Oral submucous fibrosis. A review. Aust Dent J. 1996;41(5):294–9.

    Article  PubMed  Google Scholar 

  9. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Betel-quid and areca-nut chewing and some areca-nut derived nitrosamines. IARC Monogr Eval Carcinog Risks Hum. 2004;85:1–334.

    PubMed Central  Google Scholar 

  10. Chiu CJ, Lee WC, Chiang CP, Hahn LJ, Kuo YS, Chen CJ. A scoring system for the early detection of oral submucous fibrosis based on a self-administered questionnaire. J Public Health Dent. 2002;62:28–31.

    Article  PubMed  Google Scholar 

  11. Pindborg JJ, Chawla TN, Srivastava AN, Gupta D, Mehrotra ML. Clinical aspects of oral submucous fibrosis. Acta Odontol Scand. 1964;22:679–91.

    Article  PubMed  Google Scholar 

  12. Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Ora Pathol. 1966;22:764–79.

    Article  Google Scholar 

  13. Pindborg JJ, Mehta FS, Daftary DK. Occurrence of epithelial atypia in 51 Indian villagers with oral submucous fibrosis. Br J Cancer. 1970;24:253–7.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pindborg JJ. Is submucous fibrosis a pre-cancerous condition in the oral cavity? Int Dent J. 1972;22:474–80.

    PubMed  Google Scholar 

  15. Pindborg JJ, Bhonsle RB, Murti PR, Gupta PC, Daftary DK, Mehta FS. Incidence and early forms of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol. 1980;50:40–4.

    Article  PubMed  Google Scholar 

  16. Bhonsle RB, Murti PR, Daftary DK, et al. Regional variations in oral submucous fibrosis in India. Commun Dent Oral Epidemiol. 1987;15:225–9.

    Article  Google Scholar 

  17. Mehta FS, Gupta PC, Daftary DK, Pindborg JJ, Choksi SK. An epidemiologic study of oral cancer and precancerous conditions among 101,761 villagers in Maharashtra. India Int J Cancer. 1972;10(1):134–41.

    Article  PubMed  Google Scholar 

  18. Murti PR, Gupta PC, Bhonsle RB, Daftary DK, Mehta FS, Pindborg JJ. Effect on the incidence of oral submucous fibrosis of intervention in the areca nut chewing habit. J Oral Pathol Med. 1990;19:99–100.

    Article  PubMed  Google Scholar 

  19. Gupta S, Jawanda MK. Oral submucous fibrosis: An overview of a challenging entity. Indian J Dermatol Venereol Leprol. 2021;23:768–77.

    Article  Google Scholar 

  20. Zachariah J, Mathew B, Varma NAR, Iqbal AM, Pindborg JJ. Frequency of oral mucosal lesions among 5000 individuals in Trivandrum, South India. J All India Dent Assoc. 1966;38:290–6.

    Google Scholar 

  21. Pindborg JJ, Mehta FS, Gupta PC, Daftary DK. Prevalence of oral submucous fibrosis among 50,915 Indian villagers. Br J Cancer. 1968;22(4):646–54.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wahi PN, Mittal VP, Lahiri B, Luthera UK, Seth RK, Arma GD. Epidemiological study of precancerous lesions of the oral cavity: a preliminary report. Ind J Med Res. 1970;50:1361–91.

    Google Scholar 

  23. Patil PB, Bathi R, Chaudhari S. Prevalence of oral mucosal lesions in dental patients with tobacco smoking, chewing, and mixed habits: a cross sectional. J Fam Commun Med. 2013;20(2):130–5.

    Article  Google Scholar 

  24. Hazarey VK, Erlewad DM, Mundhe KA, Ughade SN. Oral submucous fibrois: study of 1000 cases from central India. J Oral Pathol Med. 2007;36:12–7.

    Article  PubMed  Google Scholar 

  25. Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in southern India. Indian J Dent Res. 2008;19(2):99–103.

    Article  PubMed  Google Scholar 

  26. Mehrotra R, Pandya S, Chaudhary AK, Kumar M, Singh M. Prevalence of oral pre-malignant and malignant lesions at a tertiary level hospital in Allahabad, India. Asian Pac J Cancer Prev 2008;9(2):263–265.

    Google Scholar 

  27. Sharma R, Raj SS, Miahra G, Reddy YG, Shenava S, Narang P. Prevalence of oral submucous fibrosis in patients visiting dental college in rural area of Jaipur, Rajasthan. J Indian Acad Oral Med Radiol. 2012;24(1):1–4.

    Google Scholar 

  28. Agarwal A, Chandel S, Singh N, Singhal A. Use of tobacco and oral sub mucous fibrosis in teenagers. J Dent Sci Res. 3(3):1–4.

    Google Scholar 

  29. Bhatnagar P, Rai S, Bhatnagar G, Kaur M, Goel S, Prabhat M. Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: in accordance with WHO guidelines. J Fam Community Med. 2013;20(1):41–8.

    Article  Google Scholar 

  30. Burungale SU, Durge PM, Burungale DS, Zambare MB. Epidemiological study of premalignant and malignant lesions of the Oral cavity. J Acad Ind Res. 2014;2(9):519–23.

    Google Scholar 

  31. Nigam NK, Aravinda K, Dhillon M, Gupta S, Reddy S, Srinivas RM. Prevalence of oral submucous fibrosis among habitual gutkha and areca nut chewers in Moradabad district. J Oral Biol Craniofac Res. 2014;4(1):8–13.

    Article  PubMed  Google Scholar 

  32. Singh P, Mittal R, Chandak S, Bhondey A, Rathi A, Chandwani M. Prevalence of oral submucous fibrosis in children of rural area of Nagpur, Maharashtra, India. Int J Prev Clin Dent Res. 2016;3(4):243–5.

    Article  Google Scholar 

  33. Tyagi VN, More MD. Prevalence of Oral submucous fibrosis at OPD of ENT department of SMBT Institute of Medical Sciences, Nasik. J Appl Med Sci. 2018;6(1F):395–8.

    Google Scholar 

  34. More C, Rao NR, More S, Johnson NW. Reasons for initiation of areca nut and related products in patients with oral submucous fibrosis within an endemic area in Gujarat, India. Subst Use Misuse. 2020;55(9):1413–21.

    Article  PubMed  Google Scholar 

  35. Ahmad MS, Ali SA, Ali AS, Chaubey KK. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent. 2006;24(2):84–9.

    Article  PubMed  Google Scholar 

  36. Panda S, Panda BK, Pattnaik B, Naik C, Dany SS, Avijeeta A. Prevalence of oral submucous fibrosis in a tertiary care hospital of Odisha: a cross-sectional study. J Evid Based Med Health. 2020;49:2903–6.

    Article  Google Scholar 

  37. Srivastava R, Jyoti B, Pradhan D, Siddiqui Z. Prevalence of oral submucous fibrosis in patients visiting dental OPD of a dental college in Kanpur: a demographic study. J Family Med Primary Care. 2019;8(8):2612.

    Article  Google Scholar 

  38. Lay KM, Sein K, Myint A, Ko SK, Pindborg JJ. Epidemiologic study of 600 villagers of oral precancerous lesions in Bilugyun: preliminary report. Commun Dent Oral Epidemiol. 1982;10(3):152–5.

    Article  Google Scholar 

  39. Amarasinghe AAHK, Usgodaarachchi US, Johnson NW, Warnakulasuriya S. High prevalence of lifestyle factors attributable for oral cancer, and of oral potentially malignant disorders in Rural Sri Lanka. Asian Pac J Cancer Prev. 2018;19(9):2485–92.

    PubMed  PubMed Central  Google Scholar 

  40. Hosein M, Mohiuddin S, Fatima N. 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 J Cancer Prev. 2015;20(3):216–22.

    Article  PubMed  Google Scholar 

  41. Tariq H, Ahmed S, Naz M, Naureen A. Frequency of oral sub mucous fibrosis and its correlation with the level of education in patients coming to a tertiary care hospital of Karachi from January 2018 to December 2018. Asian Pac J Cancer Care. 2020;5(3):157–60.

    Article  Google Scholar 

  42. Cuc TTK, Nguyen BN, Nguyen TH. Oral mucosa and oral health status of betel chewers in Ba De Hoc Mon- Ho Chı Minh City (in Vietnamese). University of Medicine and Pharmacy; 2008. p. 91–7.

    Google Scholar 

  43. Khanh ND. Oral Cancer and Precancer Survey in Southern Provinces of Vietnam (1998). Cited by Huy`nh Anh Lan, 2006. In: Proceedings, oral cancer in the Asia Pacific—a regional update and networking. Kuala Lumpur: Faculty of Dentistry, University of Malaya, 2006. pp. 17–19.

    Google Scholar 

  44. Nguyên TBN (2006). Oral mucosa, denture and paradentitis of betel chewers in BàÐiêm Commune, Hóc Môn District, HôChí Minh City (in Vietnamese). Thesis, Faculty of Odontology, University of Medicine and Pharmacy, HôChí Minh City, 2006, pp. 15–7.

    Google Scholar 

  45. Tang JG, Jian XF, Gao ML, Ling TY, Zhang KH. Epidemiological survey of oral submucous fibrosis in Xiangtan City, Hunan Province, China. Commun Dent Oral Epidemiol. 1997;25(2):177–80.

    Article  Google Scholar 

  46. Zhang SS, Li W-H, Gao Y-J, et al. Betel-quid and oral submucous fibrosis: a cross-sectional study in Hunan province, China. J Oral Pathol Med. 2012;41:748–54.

    Article  PubMed  Google Scholar 

  47. Yang PY, Chen YT, Wang YH, Su NY, Yu HC, Chang YC. Malignant transformation of oral submucous fibrosis in Taiwan: a nationwide population-based retrospective cohort study. J Oral Pathol Med. 2017;46(10):1040–5.

    PubMed  Google Scholar 

  48. Yang S-F, Wang Y-H, Su N-Y, et al. Changes in prevalence of pre- cancerous oral submucous fibrosis from 1996 to 2013 in Taiwan: a nationwide population-based retrospective study. J Formos Med Assoc. 2018;117(2):147–52.

    Article  PubMed  Google Scholar 

  49. Shah B, Lewis MA, Bedi R. Oral submucous fibrosis in a 11-yearold Bangladeshi girl living in the United Kingdom. Br Dent J. 2001;191(3):130–2.

    Article  PubMed  Google Scholar 

  50. Laskaris G, Bovopoulou O, Nicolis G. Oral submucous fibrosis in a Greek female. Br J Oral Surg. 1981;19(3):197–201.

    Article  PubMed  Google Scholar 

  51. Aziz SR. Coming to America: betel nut and oral submucous fibrosis. J Am Dent Assoc. 2010;141(4):423–8.

    Article  PubMed  Google Scholar 

  52. McGurk M, Craig GT. Oral submucous fibrosis: two cases of malignant transformation in Asian immigrants to the United Kingdom. Br J Oral Maxillofac Surg. 1984;22(1):56–64.

    Article  PubMed  Google Scholar 

  53. Shear M, Lemmer J, Dockrat IS. Oral submucous fibrosis in South African Indians. An epidemiological study. S Afr J Med Sci. 1967;32:41–6.

    PubMed  Google Scholar 

  54. Seedat HA, van Wyk CW. Betel-nut chewing and submucous fibrosis in Durban. S Afr Med J. 1988;74(11):568–71.

    PubMed  Google Scholar 

  55. VanWyk CW. Oral submucous fibrosis. The South African experience. Indian J Dent Res. 1997;8(2):39–45.

    PubMed  Google Scholar 

  56. Ranganathan K, Devi MU, Joshua E, Kirankumar K, Saraswathi TR. Oral submucous fibrosis: a case-control study in Chennai, South India. J Oral Pathol Med. 2004;33(5):274–7.

    Article  PubMed  Google Scholar 

  57. Mohiuddin S, Fatima N, Hosein S, Hosein M. High risk of malignant transformation of oral submucous fibrosis in Pakistani females: a potential national disaster. J Pak Med Assoc. 2016;66(11):1362–6.

    PubMed  Google Scholar 

  58. Ali SM, Qureshi R, Jamal S. Prevalence of oral submucous fibrosis and use of tobacco and related products amongst school going males. Pak Oral Dent J. 2013;31:384–7.

    Google Scholar 

  59. Cai X, Yao Z, Liu G, Cui L, Li H, Huang J. Oral submucous fibrosis: a clinicopathological study of 674 cases in China. J Oral Pathol Med. 2019;48:321–5.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Oakley E, Demaine L, Warnakulasuriya S. Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia). Bull World Health Organ. 2005;83(9):656–60.

    PubMed  PubMed Central  Google Scholar 

  61. Hayes PA. Oral submucous fibrosis in a 4-year-old girl. Oral Surg Oral Med Oral Pathol. 1985;59(5):475–8.

    Article  PubMed  Google Scholar 

  62. South Asian Public Health Association. The health of South Asians in the United States: a brown paper. Berkeley, CA: South Asian Public Health Association; 2002.

    Google Scholar 

  63. More CB, Rao NR, Hegde R, Brahmbhatt RM, Shrestha A, Kumar G. Oral submucous fibrosis in children and adolescents: analysis of 36 cases. J Indian Soc Pedod Prev Dent. 2020;38(2):190–9.

    Article  PubMed  Google Scholar 

  64. Kariya P, Khobragade V, Sura S, Singh S. No age predilection for a disease like OSF. A case report of 5-year-old child. J Oral BiolCraniofac Res. 2020;10(2):153–7.

    Google Scholar 

  65. Peng Q, Li H, Chen J, Wang Y, Tang Z. Oral submucous fibrosis in Asian countries. J Oral Pathol Med. 2020;49(4):294–304.

    Article  PubMed  Google Scholar 

  66. Tilakaratne WM, Ekanayaka RP, Warnakulasuriya S. Oral submucous fibrosis: a historical perspective and a review on etiology and pathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(2):178–91.

    Article  PubMed  Google Scholar 

  67. Gupta PC. Areca nut use in India. Ind J Med Sci. 2007;61:317–9.

    Article  Google Scholar 

  68. Gupta PC, Warnakulasuriya S. Global epidemiology of areca nut usage. Addict Biol. 2002;7:77–83.

    Article  PubMed  Google Scholar 

  69. More CB, Rao NR. Proposed clinical definition for oral submucous fibrosis. J Oral Biol Craniofac Res. 2019;9(4):311–4.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Babu S, Bhat RV, Kumar PU. A comparative clinico-pathological study of oral submucous fibrosis in habitual chewers of pan masala and betel quid. Clin Toxicol. 1996;34:317–22.

    Google Scholar 

  71. Maher R, Lee AJ, Warnakulasuriya KA, Lewis JA, Johnson NW. Role of areca nut in the causation of oral submucous fibrosis: a case-control study in Pakistan. J Oral Pathol Med. 1994;23(2):65–9.

    Article  PubMed  Google Scholar 

  72. World Health Organization. (2021) WHO report on the global tobacco epidemic 2021: addressing new and emerging products. Geneva, Switzerland.

    Google Scholar 

  73. Schwartz J. AtrophiaIdiopathica Mucosae Oris. London: Demonstrated at the 11th Int Dent Congress; 1952. London.

    Google Scholar 

  74. Patil S, Doni B, Maheshwari S. Prevalence and distribution of oral mucosal lesions in a geriatric Indian population. Can Geriatr J. 2015;18(1):11–4.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral Medicine and Radiology, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India

    Chandramani B. More & Deepa Jatti Patil

Authors
  1. Chandramani B. More
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deepa Jatti Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK

    Saman Warnakulasuriya

  2. Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, The TN Dr MGR Medical University, Chennai, Tamil Nadu, India

    Kannan Ranganathan

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

More, C.B., Patil, D.J. (2023). Epidemiology of Oral Submucous Fibrosis: Prevalence and Trends. In: Warnakulasuriya, S., Ranganathan, K. (eds) Oral Submucous Fibrosis. Textbooks in Contemporary Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-031-12855-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-12855-4_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-12854-7

  • Online ISBN: 978-3-031-12855-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation