Physiotherapy in Treatment of Oral Submucous Fibrosis Related Restricted Mouth Opening

BACKGROUND: Multiple treatment approaches including surgical and non surgical therapies have been tried to improve restricted mouth opening in Oral Submucous Fibrosis (OSMF). AIM: To evaluate the effectiveness of physiotherapy in improving mouth opening, tongue protrusion and cheek flexibility in patients with OSMF. MATERIALS AND METHODS: Forty eight OSMF patients were assigned into three groups by drawing chits. Group 1: patients receiving intralesional injections of dexamethasone and hyaluronidase; Group 2: patients receiving physiotherapy; Group 3: patients receiving both intralesional injections and physiotherapy. Mouth opening, tongue protrusion and cheek flexibility was assessed in all the patients before intervention and at different time intervals of 2 weeks, 4 weeks and 6 weeks after treatment. RESULTS: Intragroup: In Group 2, the mean values of mouth opening, tongue protrusion and cheek flexibility were increased in time but were statistically insignificant. The mean values of mouth opening, tongue protrusion and cheek flexibility were markedly increased over a period of time in Group 3 and cheek flexibility was found to be statistically significant (p = 0.05). Intergroup: The mean differences of mouth opening, cheek flexibility and tongue protrusion was found to be maximum in group 3 and it was statistically significant (p=0.03) for tongue protrusion. CONCLUSION: Concurrent treatment with physiotherapy and intralesional injections was found to improve the mean mouth opening,tongue protrusion and cheek flexibility. Hence, physiotherapy can be used as an adjuvant treatment for OSMF as it is non invasive, more patient compliant and doesn't require any financial resources.