Distribution of Oral Submucous Fibrosis Cases and Malignant Transformation Rate among Bhutanese Patients Treated at Jigme Dorji Wangchuck National Referral Hospital, Bhutan

Keywords: Oral Submucous Fibrosis, Distribution, District, Bhutan


BACKGROUND: Oral Submucous Fibrosis (OSMF) is a chronic, insidious, scarring disease of the mouth often involving the palate, oro-pharynx, pharynx, esophagus, tongue and the buccal mucosa which leads to ulceration, blanching and ultimately limited mouth opening. The aim of the study is to describe the age, gender and district-wise distribution of oral submucous fibrosis cases and to assess the malignant transformation rate among the patients with oral submucous fibrosis who were treated at Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
MATERIALS AND METHOD: This is a descriptive retrospective study. The patients were clinically diagnosed by examining their mouth and by measuring their mouth opening (Inter-incisal height). Patients who had less than 3 fingers mouth opening and diagnosed as Oral submucous fibrosis (OSMF) during these three-year period from 2018 to 2020 were considered for the study.
RESULTS: There were 278 cases in total. Thimphu district had the maximum number of cases followed by Wangduephodrang and Samtse. Gasa and Haa districts had the minimum cases. More males were affected than females. The malignant transformation rate among these patients was 4.3%.
CONCLUSION: Thimphu district had the highest proportion of OSMF cases and was almost equally distributed among genders. Over 90% of the patients reported improvement without surgery while the malignancy transformation rate was 4.3%. The study recommends conducting screening in districts with high burden of OSMF cases for early diagnosis and treatment.


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Author Biographies

Pratap Singh Tamang

Department of Dentistry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.

Gyan Prasad Bajgai

Department of Dentistry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.

Hari Prasad Pokhrel

Gidakom Hospital, Ministry of Health, Thimphu, Bhutan


Das M, Manjunath C, Srivastava A, Malavika J, Ameena MVM. Epidemiology of Oral Submucous Fibrosis: A Review. Int J Oral Health Med Res 2017;3(6):126-9.

Rao NR, Villa A, More CB, Jayasinghe RD, Kerr AR, Johnson NW. Oral submucous fibrosis: a contemporary narrative review with a proposed inter-professional approach for an early diagnosis and clinical management. J Otolaryngol Head Neck Surg. 2020;49:3. https://doi.org/10.1186/s40463-020-0399-7.

Kale MV, Gaikwad NS. Oral submucous fibrosis: a study of qualitative and analytical treatment using intralesional injections: placental extract versus combination of steroid with hyaluronidase. Int J Otorhinolaryngol Head Neck Surg. 2020;6(7):1320-5. http://doi.org/10.18203/issn.2454-5929.ijohns20202786.

Ahmad MS, Ali SA, Ali AS, Chaubey KK. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent. 2006;24(2):84-9. http://doi.org/10.4103/0970-4388.26022.

Srivastava R, Jyoti B, Pradhan D, Siddiqui Z. Prevalence of oral submucous fibrosis in patients visiting dental OPD of a dental college in Kanpur: A demographic study. J Family Med Prim Care. 2019;8:2612-7. http://doi.org/10.4103/jfmpc.jfmpc_465_19.

Gondivkar SM, Gadbail AR, Sarode SC, Gondivkar RS, Patil S, Gaikwad RN, et al. Treatment outcomes of laser therapy in oral submucous fibrosis-a systematic review. J Oral Biol Craniofac Res. 2020;10(3):253-8. http://doi.org/10.1016/j.jobcr.2020.05.004.

Khare N, Patil SB, Kale SM, Sumeet J, Sonali I, Sumeet B. Normal mouth opening in an adult Indian population. Journal of Maxillofacial and Oral Surgery. 2012;11(3):309-13. http://doi.org/10.1007/s12663-012-0334-1

Li X-Y, Jia C, Zhang Z-C. The normal range of maximum mouth opening and its correlation with height or weight in the young adult Chinese population. J Dent Sci. 2017;12(1):56-9. http://doi.org/10.1016/j.jds.2016.09.002.

Passi D, Bhanot P, Kacker D, Chahal D, Atri M, Panwar Y. Oral submucous fibrosis: Newer proposed classification with critical updates in pathogenesis and management strategies. Natl J Maxillofac Surg. 2017;8(2):89-94. http://doi.org/10.4103/njms.NJMS_32_17

Chourasia NR, Borle RM, Vastani A. Concomitant Association of Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma and Incidence of Malignant Transformation of Oral Submucous Fibrosis in a Population of Central India: A Retrospective Study. J Maxillofac Oral Surg. 2015;14(4):902-6. http://doi.org/10.1007/s12663-015-0760-y.

Wan K, Kademani D. Oral Epithelial Dysplasia, Improving Outcomes in Oral Cancer. In: Kademani K. Improving Outcomes in Oral Cancer. 1st ed. Springer, Cham;2020,pp:1-12. https://doi.org/10.1007/978-3-030-30094-4.

DOI: 10.26440/IHRJ/0412.03391
Published: 2021-03-22
How to Cite
Pratap Singh Tamang, Gyan Prasad Bajgai, Hari Prasad Pokhrel. Distribution of Oral Submucous Fibrosis Cases and Malignant Transformation Rate among Bhutanese Patients Treated at Jigme Dorji Wangchuck National Referral Hospital, Bhutan. IHRJ [Internet]. 2021Mar.22 [cited 2024Jun.25];4(12):OR7-OR10. Available from: https://ihrjournal.com/ihrj/article/view/391

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