Objective: To investigate the effect of chewing areca and/or betel quid with pan masala (tobacco) on oral hard tissue, oral submucous fibrosis (OSMF), and associated molecular impairment underlying the causation of oral precancerous disorders.
Design: 365 subjects [chewers (n = 168) and non-chewers (n = 197)] who attended the Out Door Patient Department of Government Dental College and Hospital, Ahmedabad-380016, India were enrolled. Chewers had chewing habits of pan masala (tobacco), areca nut, and betel quid and nonchewers were not in the habit of chewing any products containing tobacco. Informed consent was obtained. A clinical dental examination was conducted and biological samples (saliva, blood and urine) were collected.