Oral submucos fibrosis (OSMF), a multifactorial oral potentially malignant disorder, is prevalent in South East Asia particularly India with increasing prevalence of 0.3% to 6.42% and among Chennai, South India is 8%. It is an insidious chronic disease affecting any part of the oral mucosa, sometimes pharynx usually preceded by vesicle formation and is always associated with juxtaepithelial inflammatory reaction followed by a fibroelastic change of the lamina propria  with epithelial atrophy, leading to stiffness of oral mucosa causing trismus and inability to eat. It leads to high rate of morbidity due to consequent nutritional deficiencies.

                    Currently the most accepted management of OSMF includes intralesional injection of steroids biweekly for 6 weeks. Steroids are anti-inflammatory and anti-fibrotic. But the injections are painful episodes and  can also lead to scarring. Topical dexamethasone loaded buccal bio-adhesive patch is a non invasive drug delivery system which has been used successfully in  the treatment of OSMF in a pilot study.     

                     Clinical diagnosis of OSMF is usually made based on several characteristic clinical features. But those are subjective and non reliable which leads to the need of quantitative imaging technique to visualize and measure the clinical stage, progression of the disease and its response to the treatment.                 

                     Hence this present study is designed to to assess the burning sensation (Numerical rating scale), mouth opening (interincisal distance), tongue protrusion, cheek flexibility, submucosal thickness, echogenicity (USG assessment), patient compliance in  oral submucous fibrosis patients (OSMF) managed by dexamethosone loaded bio-adhesive patch and intralesional injection at three time points, 0, 3rd and 6th week respectively