C5 Oral submucous fibrosis in paediatric patients

Abstract

Presenting complaint: This case report relates to two paediatric patients, aged 11 and 13 years, referred to the Birmingham Dental Hospital with limited oral opening. In both instances, this limitation of opening was of unknown duration but thought to be progressive in nature by the referring agent.Clinical management: On examination, the inter‐incisal opening was found to be approximately 15–20 mm. On questioning, a betel chewing habit was identified in both patients. The mucosa was found to be pale and taut in nature. Both patients and parents were counselled on the adverse effects of betel chewing and the possibility of tissue changes as a result. Symptomatic relief was provided with benzydamine hydrochloride and biopsies of the affected sites were carried out. A histological diagnosis of oral submucous fibrosis was made in both instances.Discussion: Oral submucous fibrosis is recognized as a pre‐malignant condition. It is thought to be associated with an epithelial inflammatory reaction and subsequent fibro‐epithelial change. This can lead to epithelial atrophy and later mucosal stiffening. The occurrence of oral submucous fibrosis in younger patients is extremely uncommon. This case report highlights the importance of investigating the social history of presenting patients and the need to improve patient and parent education in relation to the habit of betel nut chewing.