Prevalence of Oral Submucous Fibrosis in Patients with Oral Squamous Cell Carcinoma Reporting at Nishtar Institute of Dentistry, Multan, Pakistan

Abstract

Objective: To identify the percentage of patients with oral submucous fibrosis (OSF) among the patients with oral squamous cell carcinoma (OSCC) who presented at Nishtar Institute of Dentistry, Multan, Pakistan and to compare the demographical, clinical and habit-related characteristics of OSFpositive and OSF-negative patients.Methods: This cross-sectional study was conducted at the Department of oral and maxillofacial surgery, from June 2024 to July 2025. Total 182 OSCC cases were recruited by consecutive sampling through histopathologic diagnosis. Patients were clinically assessed for OSF and staged according to Haider et al. (2000) based on the extent of involvement and interincisal mouth opening. Analysis included age, sex, tumor site, histopathological grade, habit type, habit duration, and mouth opening.Results: OSF was present in 30.8% (56/182) of OSCC cases. There was no significant difference in mean age between patients with OSF-positive (47.6 ± 16.5 years) and OSF-negative (51.4 ± 10.1years) (p = 0.121). The most common tumor site was the buccal mucosa (54.9%), and there was a significant difference in site distribution according to the OSF status (p < 0.001). Patients with OSF had significantly reduced mouth opening compared to those with no OSF (15.0 ± 6.4 mm vs 40.6 ± 2.1 mm, respectively; p < 0.001). Habit type was significantly associated with OSF (p < 0.001) with betel quid (paan) chewing being more common among the cases with OSF.Conclusion: OSF was present in nearly one-third of OSCC cases in this cohort and was significantly correlated with the reduced mouth opening, specific tumor sites, betel quid use and poorly differentiated histology. The results in this study suggest that structured OSF screening should be included in routine clinical evaluation of OSCC patients in this patient population.