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.
In 2009, a 11-year-old Indian Muslim girl was referred to the Oral Medicine Clinic, CSM Medical University, Lucknow, India by Public Health Dentist during “School oral health care 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 seven year; the reduced mouth opening was noticed from past one year, with discomfort and a burning sensation particularly when eating hot and spicy foods.\nIntraoral examination revealed that her entire oral mucosa was pale, especially the buccal mucosa, which does not show areas of erosion and the hard palate, which was completely blanched or opaque. Her tongue, uvula and soft palate were normal.\nDental examination reveals carious lesion in posterior tooth and poor oral hygiene.\nPhysical examination reveals a mouth opening of 14 mm and absence of fibrotic bands.