Oral Submucous Fibrosis (OSF), is precancerous medical condition of mouth. It is a pre-malignant condition of oral cancer caused due to betel nut chewing.
It prevalent in people residing in South-east Asia. If untreated and unchecked it can lead to oral cancer. The major constituents of betel nut is responsible for this. Coline and copper, these two constituents cause fibroblast dysfunction and fibrosis.
Fibroblast are cells found in the connective tissues which makes fibres like collagen. They form a mesh or a network, a matrix providing the framework for different organs. Their dysfunction hampers proper growth and nutrition supply to tissues and organs. Fibrosis is injury or scarring of connective tissues.
Blanched oral mucosa, trismus (spasm of muscles of the jaw which makes the mouth tightly closed), staining of teeth and gingiva ( soft connective tissues surrounding the tooth socket) are the primary symptoms.
There are various method for Oral Submucous Fibrosis treatment. This include both medicinal methods and surgical methods. Medicinal treatment is of 2 types: conservative treatment of administrating topical drugs like triamcinolone, acetonide, orbuflomedial hydrochloride or vitamin B-complex and conventional injections like dexamethasone and hyaluronidase.
Surgical methods include removal of fibrotic tissues and replacing them with skin tissues, fresh human grafts. The method of treatment depends on the correct diagnosis of the disease. Knowledge of severity of the disease helps in the selection of correct treatment procedure.
Now, here is another study elucidating on a natural remedy for OSF. Curcumin or diferuloylmethane, an essential component of turmeric (Curcuma longa) is a well-known anti-oxidant. Its role as a OSF cure is studied in this clinical trial.
What happened in this study?
This study elucidates the extent of effectiveness of curcumin in case of Oral Submucous Fibrosis (OSF). This was a clinical trial conducted on 30 OSF patients. They were assigned into 2 groups, with 15 people in each group. One group was test group and another one was control group.
The test group were put on a regime of commercially available Curcuminoids named Longvida(400mg lozenges, daily intake of 2gm lozenges). The control group was under the steroid tenovate (0.05% of clobetasol propionate)ointment regime. This ointment had to be applied thrice a day.
Both these regimes lasted for 3 months and follow-up analysis was done at the end of 6months. Both groups were advised to regularly perform some physiotherapy exercises involving movement of the mouth and the jaws.
This mouth exercise device (MED) based had to be done for 20 min, 10 min for each side. This is done thrice a day.
OSF is diagnosed based on reduction of the interincisal distance (distance between your 2 jaws at mouth opening) in mouth opening and fibrous bands found in the oral mucosa. Patients were were asked forego the use of tobacco 1 month prior to the start of the drug regime.
The baseline for mouth opening and the fibrous bands were noted for each group at the start of the experiment. This was then compared with the results after the 3months trial and the 6 month follow-up.
Visual Analogue Scale (VAS) measurements were also monitored. This is to check burning sensation caused by intake of hot & spicy food. This is another parameter to monitor OSF and common tooth sensitivity.
Keeping all these parameters in mind the results were analyzed.
What were the results?
The results showed some drastic changes. There was a 5.93mm increase in mouth opening in the test group. This is 2.37mm deviation from the baseline. In case of the control group, the increase in the mouth opening is of 2.66mm. A meagre 1.76mm deviation from the baseline.
Burning sensation on intake of spicy food reduced in treatment group but this was not observed in control group.
The results of the test group showcased a sustained outcome, even 6months after withdrawal of the treatment. On the other hand, the control group had a relapse of disease parameters 6 months after treatment withdrawal.
Thus, it is clearly illustrated in this study that curcumin had a far more sustained effect than conventionally applied steroids used in OSF.
How did this occur?
The anti-inflammatory and anti-oxidant effects of curcumin are the chief mechanism of action against Oral Submucous Fibrosis.
The inhibition of COX-2,lipoxygenase and inducible nitric oxide synthase (iNOS) enzymes by curcumin plays a major role in this. Also the blocking of certain pro-inflammatory cytokines like IL-12, IL- 8, IL-6, TNFα reduces inflammation in the mouth. Thus affecting OSF patients by relieving the pain and burning sensation.
The anti-oxidant property of curcumin causes a scavenging effect on superoxide and hydroxyl radicals. This results in reduction of the oxidative stress (imbalance between prooxidant and antioxidant agents).
It reduces lipid peroxidation (degradation of lipids which damages tissue). All these factors are responsible for reduction in the burning sensation caused due to intake of spicy foods.
What does this mean?
Overall, this study reveals the efficacy of curcumin as an alternative cure for Oral Submucous Fibrosis. The lack of any side effects and the relative sustained effect of curcumin makes it a far better cure than conventional steroids.
Read the full study at http://www.ncbi.nlm.nih.gov/pubmed/26604488