Patients visiting the OPD with chief complaint of burning sensation, restricted mouth opening and reduced cheek flexibility will be selected for the study.

A detailed case history of these patients will be recorded and patients which are clinically diagnosed with Oral Submucous Fibrosis will be included in the present study.

Detailed information of the study will be given to all the individuals.

Patients fulfilling the Inclusion and Exclusion criteria and ready to willingly participate in the study will be enrolled in the study.

A written informed consent would be obtained.

After obtaining the consent, patients will be assigned to the groups.

The study will consist of 40 patients

The study group will be divided into two groups where Group A - 20 patients will be the control group and Group B- 20 patients will be the experimental group.

Group A patients would be treated with antioxidants and topical steroid Capsule SM Fibro (OD for 3 months) and Topical 0.1% triamcinolone acetonide oral base (Kenacort TM 0.1% Abbott, India) (apply 3 times for 3 months) For each participant initial assessment (baseline) and periodic assessment will be recorded. In initial assessment (Day 0) detailed information will be obtained through personal interview and clinical examination, after obtaining informed consent and entering all the data in case proforma. Intervention will be started immediately from a Day 0 after noting down all the clinical parameters. Patient will be instructed to take 1 capsule (Capsule SM Fibro) daily for a period of 3 months. Instructions will be given to the patient regarding the application of Topical 0.1% triamcinolone acetonide oral base. The patient will be asked to wipe the buccal mucosa with the help of sterilize cotton then take pea size of Topical 0.1% triamcinolone acetonide paste on clean finger and apply over the buccal mucosa and massage for 2 minutes thrice daily for a period of 3 months. The patient will be advised not to eat or drink anything for half an hour and then will be asked to rinse their mouth with water. Patients will be advised physiotherapy exercise using ice-cream stick four times in a day for 3 months. Patients will be recalled twice in a month for 3 months i.e. Day 0 (baseline), Day 15, Day 30, Day 45, Day 60, Day 75, Day 90 to assess for Burning sensation, Interincisal mouth opening and Cheek flexibility. Data gathered at each visit baseline as well as periodic visits will be entered in the case proforma. The photographic records for Interincisal mouth opening will be obtained at the baseline as well as the periodic visits.

Group B patients would be treated with Emblica officinalis (Amla) (systemic and 8% topical gel) Tablet Amla 500mg (Jiva Ayurveda) (OD for 3 months) and Topical 8% Amla Gel (apply 3 times for 3 months) For each participant initial assessment (baseline) and periodic assessment will be recorded. In initial assessment (Day 0) detailed information will be obtained through personal interview and clinical examination, after obtaining informed consent and entering all the data in case proforma. Intervention will be started immediately from a Day 0 after noting down all the clinical parameters. Patient will be instructed to take 1 tablet (Tablet Amla 500mg by Jiva Ayurveda) daily for a period of 3 months. Instructions will be given to the patient regarding the application of Topical 8% Amla Gel. The patient will be asked to wipe the buccal mucosa with the help of sterilize cotton then take pea size of Topical 8% Amla Gel on clean finger and apply over the buccal mucosa and massage for 2 minutes thrice daily for a period of 3 months. The patient will be advised not to eat or drink anything for half an hour and then will be asked to rinse their mouth with water. Patients will be advised physiotherapy exercise using ice-cream stick four times in a day for 3 months. Patients will be recalled twice in a month for 3 months i.e. Day 0 (baseline), Day 15, Day 30, Day 45, Day 60, Day 75, Day 90 to assess for Burning sensation, Interincisal mouth opening and Cheek flexibility. Data gathered at each visit baseline as well as periodic visits will be entered in the case proforma. The photographic records for Interincisal mouth opening will be obtained at the baseline as well as the periodic visits.

Both the groups will be advised physiotherapy exercise using ice-cream stick four times in a day for 3 months.

Clinical significance for this study includes, it can be used as a non invasive treatment modality with no side effects in the management of oral submucous fibrosis. Also self applicable topical therapy which tends to be preferred by the patients, thus reducing the number of hospital visits.