Oral Sub-mucous Fibrosis and the Use of Substitutes of Betel Quid among the People of Indian Subcontinent

Oral sub-mucous fibrosis (OSF) is a chronic disease of the oral mucosa. It is a condition predominantly seen among people of Indian origin. Betel quid consists of a mixture of areca nut, slaked lime, catechu and several condiments according to taste, wrapped in a betel leaf. Almost all habitual chewers use tobacco with or without the betel quid. OSF is a condition with a high risk of malignant transformation; to date, no conclusive etiologic agent has been identified, although plenty of data have been generated on various aspects of the disease. These include genetic, carcinogenic, immunologic, viral, nutritional, and autoimmune possibilities, all of which also have been implicated in the development of oral cancer.