Integrating Behavioural Intervention and Pharmacological Therapy in the Management of Oral Submucous Fibrosis: A Case Report
Apeksha Suryawanshi *
Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, India.
Saniya Shaikh
Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, India.
Bhakti Puranik
Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, India.
Vikram Garcha
Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, India.
Vittaldas Shetty
Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, India.
Mahesh Chavan
Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, India.
*Author to whom correspondence should be addressed.
Abstract
Oral Submucous Fibrosis (OSMF) is a chronic, progressive, potentially malignant disorder of the oral cavity strongly associated with areca nut and smokeless tobacco use. This report presents the case of a 22-year-old male patient with Stage III OSMF, who reported chronic gutkha chewing and complained of reduced mouth opening and burning sensation on eating spicy food. Clinical examination revealed blanching of the buccal mucosa, restricted tongue movements, and palpable fibrous bands. Management included structured weekly behavioural counselling sessions for tobacco cessation, pharmacological treatment with antioxidants and intralesional corticosteroid–hyaluronidase injections, and reinforcement of oral hygiene practices. Over five weeks, the patient demonstrated significant improvement, with mouth opening increasing from 14 mm to 27 mm, improved tongue protrusion, and a marked reduction in burning sensation as measured by the Visual Analogue Scale (VAS). This case highlights the importance of integrating behavioural counselling with pharmacological management for OSMF. Early incorporation of behavioural interventions not only supports sustained habit cessation but may also reduce malignant transformation risk and improve long-term prognosis.
Keywords: Areca, behavior therapy, oral submucous fibrosis, mouth neoplasms, smokeless tobacco