Microbial Shifts in Oral Submucous Fibrosis: Exploring the Role of Oral Microflora

Introduction: Oral submucous fibrosis (OSF) is a chronic, progressive scarring disorder of the oral mucosa and a high-risk precancerous condition, once limited to the Indian subcontinent, but now a global health concern. Limited research has been done regarding the bacterial involvement in OSF. This study examines the bacterial microflora in OSF patients to assess its possible role in disease progression and malignant transformation. Aims and Objectives: To evaluate the bacterial microflora in normal healthy individuals and OSF patients and to compare and correlate the above attributes for the evaluation of any alteration of bacterial microflora in OSF and normal healthy individuals so as to predict its role in progression of the disease process. Materials and Methods: Seventy-eight OSF patients and 29 normal healthy individuals were studied over 1½ years. The samples from the oral cavity were collected, cultured aseptically for the presence of aerobic and anaerobic microbes. Results: Samples from OSF patients show more Micrococcus , Staphylococcus , Klebsiella, Branhamella, and Acinetobacter , but fewer Streptococcus , Enterococcus , Diphtheroids , Bacillus , and Pseudomonas. Among anaerobes, Prevotella , Porphyromonas , Clostridium , Peptostreptococcus , Parvimonas , Eubacterium , and Peptococcus are more common, while Veillonella , Fusobacterium , and Bifidobacterium are less prevalent. Conclusion: It was observed that the variation in abundance of the isolated bacteria is similar to that found in oral cancer. Furthermore, reduction of certain commensal bacteria has also contributed in the concomitant rise of pathogenic bacteria already reported for their carcinogenic potential. Hence, it can be opined that these microbes are likely playing a plausible biological role in the initiation and progression of this premalignant disease.