[Downloaded free from http://www.indianjcancer.com on Monday, August 18, 2014, IP: 218.241.189.21] || Click here to download free Android application for this journal younger generation an aggravated symptoms and Gutka syndrome and oral increased incidence of OSF is on a rise. In milieu submucous fibrosis: Few of these observations and impending cataclysm is a possibility, it is imperative that predictive assays are observations taken up to identify the premalignant status in these abusers. This will also help the medical fraternity with information for the need of counseling and medical Sir, intervention so that the productive population is not In response to the article by Chaturvedi in the affected.We would like to congratulate the author for Indian Journal of Cancer,[1] we wish to make a few an excellent documentation of the clinical spectrum of observations. oral changes associated with areca nut chewing or gutka chewing. Introduction of a newer terminology may not The proposed new terminology of gutka or areca effectively change the management of OSF but will nut chewer’s syndrome to the already existing well- emphasize the role of the etiologic agent, which is a known premalignant condition—oral submucous fibrosis sleeping carcinogen in our society over many centuries. (OSF)—is interesting as a synonym. It is understood by the scientific community that areca nut and its various Madathil LP, Rao PS commercial preparations could lead to OSF,[2,3] presenting Department of Oral Pathology and Microbiology, ABSM Institute as a wide clinical spectrum as narrated by the author. of Dental Sciences, Nitte University, Dearalakatte, Traditionally, pan chewing is a habit, which was prevalent Mangalore - 575 018, Karnataka, India as a cultural or social habit over hundreds of years in different parts of the Indian subcontinent and Asian Correspondence to: Prof. Lal P. Madathil, countries.[4] However, the newer commercial preparations, E-mail:[email protected] which are widely used by the younger age group and among certain occupational sectors, are alarming. References In a recent epidemiologic survey conducted by us 1. Chaturvedi P. Gutka or areca nut chewer’s syndrome. Indian J (unpublished data) in Karnataka among the truck drivers Cancer 2009;38:170-2. 2. Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Pindborg JJ, Mehta to assess the oral health status, the following observations FS. Etiology of oral submucous fibrosis with special reference to were made, which could be of interest in the present the role of areca nut –chewing. J Oral Pathol Med 1995;24:142-52. context. Among a study group of 260 truck drivers who 3. Caniff JP, Harvey W. The etiology of oral submucous fibrosis. The participated, 187 (72%) observed to be using gutka stimulation of collagen synthesis by extracts of areca nut. Int J Oral Surg 1981;10:163-7. preparations, 132 (50.76%) gutka and pan chewing, and 4. Gupta PC, Sinor PN, Bhonsle RB, Pawar VS, Mehta HC. Oral 79 (30.38%) only pan chewing as a recreational habit. submucous fibrosis in India: A new epidemic? Natl Med J India Two hundred and thirty-six (90.76%) of them were 1998;11:113-6. exclusively smokers (beedies or cigarettes). Gutka chewing is preferred over the conventional pan as there is no need Access this article online of spitting, unlike the latter. Further, a wide spectrum Quick Response Code: Website: of pathological manifestations (burning mouth, mucosal www.indianjcancer.com pallor or mucosal stiffness) were observed much earlier DOI: than (less than three years) in the conventional pan 10.4103/0019-509X.73550 eaters, suggesting advancement of the pathological events. PMID: ***************************** A buried wisdom tooth[1] may not necessarily be a sequel to OSF as the incidence of impacted wisdom tooth among the Indian population is a common finding. In an OSF patient with partially or fully impacted wisdom tooth, the dense fibrous bands may Myeloid proliferation in hinder the eruptive process. Abnormal alignment of teeth[1] because of pan or gutka chewing may not be a a newborn with Down feature of the condition, as the disease process has not shown to be causing such hard tissue changes in the syndrome supporting tissues of periodontium. Sir, With gutka practice on a rise, especially with the Approximately 10% of the newborns with Down 470 Indian Journal of Cancer | October–December 2010 | Volume 47 | Issue 4 470 CMYK.