Oral Submucous Fibrosis — MFDS Part 1 MCQ

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ModerateOral PathologyOral Submucous FibrosisMFDS Part 1

A 34-year-old patient has progressive limitation of mouth opening, oral burning when eating spicy food, diffuse blanching of the buccal mucosa and palpable submucosal fibrous bands. Which habit is most strongly associated with this condition?

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Correct answer: B — Betel quid (areca nut) chewing

The clinical features indicate oral submucous fibrosis: mucosal burning and blanching, palpable fibrous bands and progressive restriction of mouth opening. The condition is most strongly associated with chronic areca nut chewing, commonly in betel quid or commercial areca preparations. Areca alkaloids promote abnormal collagen production and reduced collagen breakdown, producing progressive subepithelial fibrosis. Oral submucous fibrosis is an oral potentially malignant disorder and requires cessation advice and long-term surveillance. Tobacco smoking and alcohol consumption are important risk factors for oral squamous cell carcinoma, but neither is the principal cause of this characteristic fibrosing disorder. Cannabis and khat chewing are also not established primary causes of oral submucous fibrosis.

Reference: Global expert consensus on oral submucous fibrosis: Standardizing care, surveillance, and prevention strategies, 2026. https://pubmed.ncbi.nlm.nih.gov/42064137/