A 9-year-old boy presented with a chief complaint of gradual reduction in mouth opening since the last 6 months (). History of present illness revealed decrease in mouth opening since 1 year with inability to eat and maintain proper oral hygiene. He also complained of burning sensation in the mouth since 1 year while consumption of spicy food and decreased salivation since 7–8 months.\nThe patient gave a history of tobacco and betel nut chewing, 20–25 times per day since 4 years and used to keep it in buccal vestibule on both sides for about 3–4 min before swallowing.\nClinical examination revealed a maximum interincisal distance of 11 mm. On intraoral examination, labial and buccal mucosa were blanched and inelastic, with vertical and circular fibrous bands palpable on both sides, including the lower lip, upper lip, () buccal mucosa and reteromolar region. Vestibular mucosa, palatal mucosa and floor of the mouth also showed blanching. Tongue had restricted movements.\nHistopathologically, H&E-stained section showed juxtaepithelial hyalinisation and collagen fibres were arranged in separate bundles with dense inflammatory infiltrate.
A 12-year-old boy presented with difficulty in mouth opening () and burning sensation on consumption of spicy food since last 8 months. Maximum interincisal distance was 11 mm, which has increased significantly after conservative management (). The patient gave a history of chewing tobacco and betel nut pouches 20–30 per day since 6 years. On intraoral examination, vertical and circular fibrous bands were palpable over lower lip, upper lip, labial and buccal mucosa.\nHistopathologically, H&E-stained section showed collagen fibres were arranged in separate bundles with dense inflammatory infiltrate, also showed juxtaepithelial hyalinisation.