What is LOCKED JAWS (Oral SubMucous Fibrosis, OSF)?
Oral submucous fibrosis (OSF/OSMF), is also called as Locked jaws is a chronic debilitating disease of the oral cavity characterized by inflammation and progressive fibrosis of the submucosal tissues. Locked Jaws results in marked rigidity and an eventual inability to open the mouth. The buccal mucosa is the most commonly involved site, but any part of the oral cavity can be involved, even the pharynx.
Why Gutkha and Pan Masala Causes OSF
Nowadays Chewable (Pan-Masala, Gutkha, Kharra, chewable tobacco) has become a “Status Symbol”. This habit is common in all socio-economical strata and age group. Laborers, High class Executive, School Going Kid, Collegians, Housewives everybody falls prey to these temptations of so-called “freshening” his/her mouth with these “Slow Poisons”.
According to various studies carried out at national and international levels, it has been proved beyond doubt that Gutkha and Pan Masala contains ‘Mutagens’ which can change our normal tissues in to cancer tissues, and can cause a progressive disease called, “ Oral Sub Mucous Fibrosis (OSF)”. After some time of chewable abuse ,the skin loses its elasticity. Thus, the disease has been termed as Oral (meaning mouth), Sub mucous (meaning skin below the delicate skin of mouth) and Fibrosis (meaning hardening and scarring). Its acronym is OSF.
As far as clinical experience goes, a majority of cases of OSF can be directly linked toGutkha& Pan Masala chewing as a major contributory factor among many other like Smoking, Supari chewing and consumption of spicy foodstuff. Many scientists believe that ill effects of chemicals like capsaicin (found in chilies) and arachidene and aracholine (found in Supari) is the major cause of OSF.
What causes locking of jaws?
Locked Jaws, Oral sub mucous fibrosis (OSF)is a common condition occurring due to consumption of tobacco, pan-masala, gutkha, areca nut. Normal mouth opening is 40mm. Fully open mouth can vertically accommodated 4-fingers. OSF causes gradual decrease in mouth opening. Situation may come when OSF patient is unable to open mouth and front teeth are to be removed to have liquefied food by straw.
The duration of Pan-Masaa and Gutkha chewing before the development of Locked Jaws varies from a few months to many years, probably dependent on the composition of the Pan-Masaa and Gutkha and extent of the habit as well as genetic and other susceptibility factors
Arecoline, an active alkaloid found in Pan-Masaa and Gutkha, stimulates fibroblasts to increase production of collagen by 150%. In one study, arecoline was found to elevate the mRNA and protein expression of cystatin C, a nonglycosylated basic protein consistently up-regulated in a variety of fibrotic diseases, in a dose-dependent manner in persons with oral submucous fibrosis.
Locked Jaws has a high rate of morbidity because is causes a progressive inability to open the mouth, resulting in difficulty eating and consequent nutritional deficiencies. Locked Jaws also has a significant mortality rate because of it can transform into oral cancer, particularly squamous cell carcinoma, at a rate of 7.6%.