Oral submucous fibrosis (OSF) is characterized by abnormal collagen deposition. It is a precancerous disorder and transforms into a malignant tumor in 1.5–15% of all cases. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation, and restricted mouth opening. All of these greatly interfere with patient quality of life. The present review introduces OSF from a molecular perspective and summarizes what is known about its underlying mechanisms, diagnostic biomarkers, and therapeutic interventions. In addition to the aggressive treatment of OSF, its prevention is also important. Future research should, therefore, focus on improving the oral health literacy of the patients susceptible to OSF.
Causative factors of OSF include autoimmunity, vitamin B, C, and iron deficiencies, chewing betel nut, consumption of spicy foods, human papilloma virus (HPV) infection, and genetic mutations. Epidemiological studies have shown that chewing betel nut is one of the most significant risk factors for OSF Among OSF patients in China, 62.3% have the habit of chewing betel nuts . Certain studies also reported that habits such as chewing and smoking tobacco and drinking alcohol increase the risk of OSF A study in Taiwan indicated that a high proportion of betel quid chewers are also tobacco smokers (86%) or alcohol drinkers (74%) Chewing betel nut and tobacco together substantially increases the incidence of OSF Other studies confirmed that drinking alcohol and chewing betel nut have an additive effect on OSF induction