Clinical and functional staging of oral submucous fibrosis

Objective: To investigate the association of location of hands in oral subm ucous fibrosis and extent of mouth-opening. Design: Cross-sectional study. Setting: University hospital, Pakistan. Subjects: 325 patients who presented with oral submucous fibrosis in Karach i between January 1992 and October 1994, of whom 288 had data sufficient fo r analysis. Main measures: Location of fibrous bands in the mouth and interincisal dist ance (mm). Results: All subjects with labial bands had bands in the fauces, and all bu t one who had labial bands also had buccal bands. All those with buccal ban ds also had bands in the fauces, Of those with buccal bands, 42% did not ha ve labial bands. The proportion of patients with bands in all three sites i ncreased from functional stage A (interincisal opening less than or equal t o 10 mm) to stage C (interincisal opening greater than or equal to 20 mm) w ith a simultaneous reduction in the proportion of people with bands in one or two sites (X-2 = 10,5, df = 4, P < 0.0001). Conclusions: Bands are common at the back of the mouth in mild cases of ora l submucous fibrosis and, as the disease increases in severity, are more li kely to be found anteriorly as well.