Method: The records of 28 patients, treated for OSF in the Department of Oral Medicine, Royal London Hospital were audited retrospectively for the presenting complaints, initial clinical features, risk factors, biopsy results and management outcomes.
Result: The majority of patients affected by OSF were of Bangladeshi origin (50%) followed by Indian (25%). All patients gave a history of betel chewing except two. A clear majority of 18 patients were long term betel quid users. Fibrous banding was detected in 75% of the patients, restricted mouth opening in 71%, Lichenoid appearances in 57%, leukoplakia in 54% and desquamative gingivitis in 11%. The most common histological findings were hyperkeratosis (56%) and OSF (53%). Dysplasia was found in 12 patients, nine of whom have been using betel quid for more than 6 years. Management strategies included cessation advice, jaw exercises and dietary advice. Prescribed medication and supplements were given to 79% of patients. The majority of patients had improvement or complete resolution of the oral symptoms including mouth opening and oral soreness.
Conclusion: Betel chewing has a detrimental effect on the oral health of the population of east London. Our study showed the importance of a systematic approach in the diagnosis and management of betel quid users. Further studies into the association between the betel quid related oral changes and the development of dysplasia or carcinoma will help in identifying the subgroups that are most at risk of developing oral cancer.