Red flags in oral submucous fibrosis

Pain

Bleeding

Halitosis 

Loose teeth

Recent onset trismus 

These are red flags to suspect malignancy in Oral sub mucous fibrosis. 

Oral Cancer in India

This is a common picture in India especially among the labour class where the form of smoke known as Bidis is common along with tobacco either as inhalation or in chewable form. First Oral Submucous fibrosis develops with restriction of mouth opening and then some form of non healing ulcer or growth erupts. Because of ignorance and poverty, there is often delay in treatment. No wonder, Oral cancer is most common form of cancer in this subcontinent of Asia

Progression of Leukoplakia tongue over years.

Tongue Lesion on 03 Dec 2011.

This is a common site in India where people chew tobacco and beetle nuts.This patient had this whitish lesion on lateral part of tongue for last one year and it is progressively increasing in size.

Same patient as above on 22 Jan 2020

patient lost to follow up but seen by other doctors. got biopsied multiple times and again presenting with a painful ulcer just ahead of white patch. this time lesion feels indurated. Multiple biopsy of the lesion taken and sent for HPE.