Question

A 32-year-old female with a long-standing history of tobacco chewing since the age of 14 presents with restricted mouth opening. Clinical examination reveals no oral ulcers. What is the most probable diagnosis?

• A. Oral submucous fibrosis
• B. Lichen planus
• C. Oral thrush
• D. Carcinoma of the buccal mucosa

Hint:

Areca nut and tobacco chewing are major risk factors for oral submucous fibrosis, which presents with burning sensation and progressive trismus.

Answer 1

The Correct Option is A

Step 1: Identify the key history.
The patient has a long history of tobacco chewing since adolescenceChronic areca nut and tobacco use is strongly associated with oral submucous fibrosis (OSMF)
Step 2: Analyze the main clinical feature.
Restricted mouth opening (trismus) is a hallmark feature of oral submucous fibrosisIt occurs due to progressive fibrosis of the oral mucosa and underlying connective tissues
Step 3: Evaluate other options.
(B) Lichen planus: Presents with white striae or erosive lesionsNot typically associated with severe restriction of mouth opening
(C) Oral thrush: A fungal infectionCharacterized by white curd-like plaquesNot associated with fibrosis or trismus
(D) Carcinoma of the buccal mucosa: May present with ulcer or massThe question states no oral ulcers, making this less likely
Step 4: Conclusion.
Chronic tobacco use with progressive restriction of mouth opening strongly indicates oral submucous fibrosis