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.
In 2011, another 10-year-old Indian Muslim boy who had not been attending school at all was referred to the Oral Medicine Clinic, CSM Medical University, Lucknow, India by Public Health Dentist during the “Community oral health screening program”, with a complaint of reduced mouth opening, discomfort and a burning sensation particularly when eating spicy foods.\nPatient showed history of areca nut chewing since six year; the reduced mouth opening was noticed from past eight month, with discomfort and a burning sensation particularly when eating hot and spicy foods and loss of gustatory sensation.\nClinical examination of soft tissue of oral cavity reveals blanched or opaque appearance of mucosa, reduced mobility of the soft palate and tongue, loss of tongue papillae and dryness of the mouth.\nDental examination reveals dental fluorosis in the anterior teeth, carious lesion in posterior tooth and a poor oral hygiene.\nPhysical examination reveals mouth opening is 13 mm, with presence of palpable fibrous band especially in the retro molar area but does not involve the uvula and tonsil.