Effect of betel chewing, tobacco smoking and alcohol consumption on oral submucous fibrosis: a case-control study in Sri Lanka.
ABSTRACT Oral submucous fibrosis (OSMF) is a chronic, insidious, disabling potentially malignant condition of the oral mucosa seen predominantly in south and Southeast Asia. No reports are hitherto available on the aetiological factors of OSMF based on Sri Lankan patients.
A total of 74 patients with OSMF and 74 controls who consecutively attended the Oral Medicine clinic at the Dental Hospital (Teaching) Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were included in the study. Binary logistic regression analyses were performed to model the influence of betel chewing, smoking and alcohol use and to determine the effects of different combinations of chewing habits on OSMF.
Betel chewing was the only significantly associated factor in the aetiology of OSMF (OR = 171.83, 95% CI: 36.35-812.25). There were no interaction effects of chewing, smoking and alcohol consumption in the causation of OSMF.
The present study has shown a strong association of betel quid chewing (including tobacco as an ingredient) with the causation of OSMF.
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ABSTRACT: Oral submucous fibrosis is a chronic disabling disease developing in up to 0.5% of the estimated 500 million habitual chewers of the "betel" quid. The quid, or chew, usually comprises a leaf of the Piper betel vine in which is wrapped fragments of the nut of Areca catechu, together with slaked lime and varied additives, including tobacco. The precise aetiology of oral submucous fibrosis (OSF) remains obscure, but epidemiological and animal studies have pointed to a close association with the prolonged usage of A. catechu nuts. Epithelial atypia and epidermoid carcinoma have been reported in 15% and 7%, respectively, of patients with established OSF. Preparations from varieties of A. catechu nuts have been tested for their ability to stimulate collagen synthesis in microwell cultures of human fibroblasts, using a pulse of 3H-proline and subsequent analysis of the cultures for radioactive collagen. Crude extracts of three varieties of areca nuts were extracted with ethanol and lyophilised before dilution in the culture medium. Control media contained identical concentrations of ethanol where appropriate. The three extracts at a concentration of 10 micrograms/ml stimulated collagen synthesis by approximately 150%, suggesting that this effect might be involved in the aetiology of oral submucous fibrosis.International Journal of Oral Surgery 02/1981; 10(Suppl 1):163-7.
- Cancer 11/1969; 24(4):832-49. · 5.20 Impact Factor
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ABSTRACT: The purpose of the investigation was to compare the morphology of fibroblasts cultured from healthy oral mucosa and mucosa of patients with oral submucous fibrosis (OSF) and to collate the occurrence of cell types of similar morphology. Cells cultured from biopsy specimens from the buccal mucosa of six subjects who did not chew the areca nut and six patients with OSF who chewed areca nut were grown according to standard techniques. Ninety cells per cell line were recorded daily for 8 days, classified into types F1, F2 and F3 according to their morphology, and the results statistically analyzed. We found that there was a relative increase of F3 cells in relation to F1 cells in OSF, resulting in the ratio of F3 to F1 cells being significantly larger in OSF than the ratio in the controls. As it has been reported that F3 cells in rat connective tissues produce significantly more collagen types I and III than F1 cells, we concluded that a change of fibroblast population has occurred in OSF and that this relative increase of F3 cells in humans, which could be committed to the production of large quantities of collagen, can be an explanation for the excessive collagen formation in OSF.Journal of Oral Pathology and Medicine 03/1997; 26(2):69-74. · 2.06 Impact Factor