{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:52:15Z","timestamp":1772160735532,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100023911","name":"British Association of Oral and Maxillofacial Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023911","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Oral Pathology Medicine"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although areca nut chewing is an established risk factor, its low prevalence among nut chewers indicates additional factors likely facilitates pathogenesis. We recently demonstrated high fluoride levels in smokeless tobacco products and hypothesized a potential pathological role of fluoride in OSMF. Further exploring this novel role, this study compared fluoride levels in tissue, serum, and saliva samples from OSMF patients and healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The ethically approved study included 25 clinically confirmed OSMF patients and 25 healthy matched controls. OSMF cases underwent buccal mucosal incisional biopsy, while controls had buccal mucosa tissue sampling during third molar removal. Fasting venous blood and unstimulated saliva were collected. Fluoride levels were analysed using ion chromatography and expressed as median (IQR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      OSMF cases showed significantly higher fluoride concentrations compared with controls in tissue biopsies (30.1 vs. 0\u2009mg\/kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), serum (0.4 vs. 0\u2009mg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and saliva (1.3 vs. 0\u2009mg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Majority (68%) of controls had undetectable fluoride levels across all samples. Tissue fluoride weakly correlated with OSMF severity (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.158,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.334).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The preliminary findings demonstrated increased tissue fluoride levels in OSMF patients compared with healthy controls. Along with a previous study showing high fluoride content in smokeless tobacco products, these findings provided early evidence suggesting fluoride could play a contributory role in OSMF pathogenesis. Further large\u2010scale investigation is warranted to definitively establish whether the association between fluoride exposure and OSMF is indicative of causation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jop.13527","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T18:19:30Z","timestamp":1709144370000},"page":"226-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of possible role of fluoride in pathogenesis of oral submucous fibrosis: A pilot study"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2032-4526","authenticated-orcid":false,"given":"Gururaj","family":"Arakeri","sequence":"first","affiliation":[{"name":"Department of Head and Neck Oncology HCG Cancer Hospital  Bengaluru India"},{"name":"Department of Oral and Maxillofacial Surgery Saveetha Dental College and Hospital  Chennai India"},{"name":"Department of Oral and Maxillofacial Surgery HKDET Dental College and Hospital  Humnabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6167-5114","authenticated-orcid":false,"given":"Vishal","family":"Rao US","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology HCG Cancer Hospital  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shekar","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology HCG Cancer Hospital  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sateesh","family":"Kunigal","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology HCG Cancer Hospital  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roopa","family":"Reddy","sequence":"additional","affiliation":[{"name":"Center for Incubation, Innovation, Research and Consultancy (CIIRC) Jyothy Institute of Technology  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murugesan","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Saveetha Dental College and Hospital  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverley","family":"Hale","sequence":"additional","affiliation":[{"name":"Institute of Allied Sciences University of Chichester  Chichester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Department of Oral &amp; 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