Oral submucous fibrosis: an update on current theories of pathogenesis

Abstract

Over the last 40 years, many theories linking oral submucous fibrosis (OSMF) to various risk factors have been proposed. The common Asian habit of repeatedly chronically exposing the oral mucosa with spicy, pungent foods and irritants like supari (areca nut), paan (betel leaves), tobacco (through chewing or smoking) have all been incriminated as causative agents. Systemic factors like nutritional deficiency, genetic predisposition and autoimmunity have also been proposed in the pathogenesis of OSMF. However the precise aetiology of OSMF is still unknown and no conclusive evidence has been found despite many extensive investigations on implicated factors. Most of the ideas proposed have been derived from existing clinical and epidemiological data. We present a comprehensive review of the various theories regarding the pathogenesis of the condition, but have not concentrated on malignant transformation in this article.

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