K13.5

Clinical Causes: Chronic chewing of areca nut, betel quid, or pan masala containing areca nut and other ingredients Use of tobacco in various forms, including smoking and smokeless tobacco Allergic reactions or hypersensitivity to certain ingredients in chewable preparations Genetic predisposition and familial susceptibility Nutritional deficiencies, particularly iron and vitamins A, B, and C Environmental factors such as irritation from rough or sharp-edged dental appliances

Key Symptoms: Feeling of stiffening or burning in the mouth Reduced mouth opening (trismus), making it difficult to speak or eat White, leathery patches or opaqueness on the mucosa of the cheeks, palate, tongue, or gums Difficulty in chewing, swallowing, or speaking over time Sensations of tingling or numbness in the affected areas Loss of flexibility in the oral tissues leading to restricted movement Muscle discomfort or soreness

Diagnosis Path: Medical history review focusing on habit history, including areca nut and tobacco use Physical examination of oral tissues to assess the extent of fibrosis Biopsy of affected tissues for histopathological examination, which shows collagen deposition and epithelial changes Assessment of mouth opening and functions such as speech and chewing Imaging studies in some cases to evaluate the degree of fibrosis or underlying involvement

Treatment Protocols: Cessation of areca nut, betel quid, and tobacco consumption Nutritional support, including supplementation of vitamins and minerals Medications such as corticosteroids to reduce inflammation and fibrosis Antioxidants that may help improve tissue health Physiotherapy exercises to improve mouth opening and preserve tissue flexibility Surgical procedures in severe cases, including fibrous band release or reconstructive surgeries Regular follow-up for monitoring progression and early detection of any malignant transformation