title: A comparative clinico-pathological study of oral submucous fibrosis in habitual chewers of pan masala and betelquid.
abstract: BACKGROUND
  Oral submucous fibrosis associated with chewing of betel nut products has an estimated prevalence of 0.2-1.2% in India. The increasing use of pan masala/gutkha, a mix of tobacco and a less moist form of betelquid lacking the betel leaf, seems associated with an earlier age of onset of oral submucous fibrosis.
  
  
  METHODS
  A prospective study examined the in vivo effects of pan masala/gutkha and betelquid chewing on buccal mucosal cytology in 50 patients with oral submucous fibrosis and 40 controls.
  
  
  RESULTS
  The percentage of nucleolated intermediate cells or proliferative fraction of buccal mucosa cells was significantly higher in all habitual chewers than controls. Pan masala/gutkha chewers presented with oral submucous fibrosis after 2.7 +/- 0.6 y of use whereas the betelquid users presented with oral submucous fibrosis reported 8.6 +/- 2.3 y of use (p < 0.05).
  
  
  CONCLUSIONS
  Habitual chewing of pan masala/gutkha is associated with earlier presentation of oral submucous fibrosis than betelquid use. Factors which may be responsible for these differences are the tobacco content, the absence of the betel leaf and its carotenes and the much higher dry weight of pan masala/gutkha.
authors.affiliation: Food Toxicology Research Centre, National Institute of Nutrition, Hyderabad, India.
authors.forename: S
authors.initials: S
authors.lastname: Babu
authors.forename: R V
authors.initials: RV
authors.lastname: Bhat
authors.forename: P U
authors.initials: PU
authors.lastname: Kumar
authors.forename: B
authors.initials: B
authors.lastname: Sesikaran
authors.forename: K V
authors.initials: KV
authors.lastname: Rao
authors.forename: P
authors.initials: P
authors.lastname: Aruna
authors.forename: P R
authors.initials: PR
authors.lastname: Reddy
mesh_terms: D000328:Adult; D001114:Areca; D003581:Cytodiagnosis; D006801:Humans; D009055:Mouth / Q000473:pathology*; D009914:Oral Submucous Fibrosis / Q000209:etiology / Q000473:pathology*; D010946:Plants, Medicinal; D010947:Plants, Toxic; D011446:Prospective Studies; D014026:Nicotiana; D014029:Tobacco Use Disorder / Q000150:complications