An 11-year-old boy presented with a chief complaint of difficulty in eating and restricted mouth opening () since 1 year. On asking leading questions, the patient gave a history of burning sensation over buccal mucosa while consuming spicy food since 1 year. The patient had a habit of tobacco and betel nut chewing 15–20 times per day since 5 years. He also had a habit of keeping the quid in the buccal vestibule.\nOn clinical examination, maximum interincisal distance was 13 mm. Intraoral examination revealed palpable fibrous bands over labial and buccal mucosa along with blanching of palate, soft palate and floor of mouth (). Tongue movements were restricted and the uvula was shrunken. Histopathological examination showed moderately hyalinised collagen in connective tissue stroma. Few areas show thickened collagen bundles. Inflammatory exudate chiefly consists of lymphocytes and plasma cells.
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.