Table 4 Intra- and extra- oral manifestations of OSMF at different stages
Features | Early stage | Moderate stage | Advanced stage |
|---|---|---|---|
Intra oral | Stomatitis, excessive salivation, burning sensation, blanching of oral mucosa, blister formation, presence of thin palpable fibrous bands, sparse brown/black pigmentation. | Stomatitis, burning sensation, xerostomia, loss of taste sensation, gradual decrease in mouth opening, difficulty in whistling, vesicle formation, petechiae, rigid oral mucosa, difficulty in blowing the cheeks, defective gustatory sensation, blanching of oral mucosa – especially of soft palate, buccal mucosa, labial mucosa, tongue, floor of mouth, and faucial pillars. Presence of thick palpable fibrous bands, shrunken uvula with altered shape (inverted, hockey stick, bud like, deviated). | Stomatitis, burning sensation, xerostomia, reduction in mouth opening, restricted tongue movement, loss of taste sensation, Unable to blow the cheeks, defective gustatory sensation, inability to whistle, blanching of oral mucosa: esp. soft palate, buccal mucosa, labial mucosa, tongue, floor of mouth, and faucial pillars. Loss of suppleness of mucosa, mottled or opaque or white marble like appearance of oral mucosa, thick palpable fibrous bands on buccal and labial mucosa, de-papillation of tongue, shrunken uvula with altered shape (inverted, hockey stick, bud like, deviated), involvement of the pharyngeal and esophageal mucosa. |
Extra oral | No Significant extra oral features are observed. | Prominent masseter muscle, nasal twang, sunken cheeks, thinning of lips, difficulty in deglutition, loss of naso-labial fold, prominent antegonial notch, hoarseness of voice, mild hearing impairment, weight loss. | Hypertrophic and stiff masseter muscle, nasal intonation of voice, sunken cheeks, multiple folds on cheeks when attempting wide opening of mouth, thinning of lips, difficulty in deglutition, loss of naso-labial fold, prominent antegonial notch, hoarseness of voice, severe hearing impairment, severe weight loss, hoarseness of voice, difficulty in deglutition, atrophy of facial musculature. In severe cases, radiographically, there is alteration in condylar form and fibrous ankylosis of the temporomandibular joints. |