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 Table of Contents  
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 51

Medical management of oral submucous fibrosis

Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India

Date of Web Publication2-Mar-2015

Correspondence Address:
Vagish Kumar Laxman Shanbhag
Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore - 575 018, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2347-5625.143766

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How to cite this article:
Shanbhag VL. Medical management of oral submucous fibrosis. Asia Pac J Oncol Nurs 2015;2:51

How to cite this URL:
Shanbhag VL. Medical management of oral submucous fibrosis. Asia Pac J Oncol Nurs [serial online] 2015 [cited 2021 Oct 18];2:51. Available from: https://www.apjon.org/text.asp?2015/2/1/51/143766


About 5 million people in India have oral submucous fibrosis and recent data suggest a male predominance. Age group between second and third decade is commonly involved. Risk of malignant transformation ranges from 7% to 30%. [1] Restricted mouth opening in oral submucous fibrosis makes examination and early diagnosis of cancer difficult. Medical management is the treatment of choice in early stages of this chronic precancerous condition. A patient has to undergo dietary habit counseling and stop intaking arecanut, tobacco and spicy food. Patient's diet should include proteins, vitamin D, E and B complex and micronutrients.

Intralesional steroids such as dexamethasone are the main treatment modality. These are injected submucosally into the fibrotic bands weekly for 6 to 8 weeks with regular monitoring of mouth opening. They are commonly used with hyaluronidase, a proteolytic enzyme. Antioxidants like alpha lipoic acid and lycopene are also commonly used as first line of treatment. Lycopene is anti-poliferative, anti-inflammatory and anti-oxidant. Antioxidants restrict the damage caused by reactive free radicals to cells and cellular components. [1],[2] Novel therapies include zinc actetate tablets for 4 months, 50 mg three times daily, and vitamin A 25,000 IU, once daily, with regular follow-up at an interval of 1 month. [3] Also, Salvianolic acid B, an antifibrotic, which is used with triamcinolone acetonide represents the promising newest mode of management. Salvianolic acid B has antifibrosis, anticoagulation, antitumor activities. [4] Turmeric, immunomodulatory drug levamisole, vasodilator pentoxyfilline, placental extract, interferon gamma, spirulina, colchicine, herbal antioxidants oxitard and Aloe vera are also promising in the management of this chronic disease. [1],[2],[5],[6],[7] Antioxidant property of spirulina is attributed to high amount of beta carotene and superoxide dismutase. Colchicine has antifibrotic and anti-inflammatory properties. [5],[6]

  References Top

Arakeri G, Brennan PA. Oral submucous fibrosis: An overview of the aetiology, pathogenesis, classification, and principles of management. Br J Oral Maxillofac Surg 2013;51:587-93.  Back to cited text no. 1
Yoithapprabhunath TR, Maheswaran T, Dineshshankar J, Anusushanth A, Sindhuja P, Sitra G. Pathogenesis and therapeutic intervention of oral submucous fibrosis. J Pharm Bioall Sci 2013;5:(Suppl 1):S85-8.  Back to cited text no. 2
Dhariwal R, Mukherjee S, Mohanty SP, Chakraborty A, Ray GJ, Chaudhuri K. Zinc and vitamin A can minimise the severity of oral submucous fibrosis. BMJ Case Rep. 2010. doi: 10.1136/bcr.10.2009.2348.  Back to cited text no. 3
Jiang WX, Zhang Y, Yang KS, Zhang H, Lu K, Sun LG. Efficacy of salvianolic acid B combined with triamcinolone acetonide in the treatment of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:339-44.  Back to cited text no. 4
Mulk BS, Deshpande P, Velpula N, Chappidi V, Chintamaneni RL, Goyal S. Spirulina and pentoxyfilline - a novel approach for treatment of oral submucous fibrosis. J Clin Diagn Res 2013;7:3048-50.  Back to cited text no. 5
Krishnamoorthy B, Khan M. Management of oral submucous fibrosis by two different drug regimens: A comparative study. Dent Res J (Isfahan) 2013;10:527-32.  Back to cited text no. 6
Patil S, Halgatti V, Maheshwari S, Santosh BS. Comparative study of the efficacy of herbal antioxdants oxitard and aloe vera in the treatment of oral submucous fibrosis. J Clin Exp Dent 2014;6:e265-70.  Back to cited text no. 7


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