Insight into history of Areca nut and oral submucous fibrosis: a narrative review

Oral Submucous Fibrosis (OSF) is an age old disease. It is even mentioned by Suśruta, one of the earliest surgeons of the recorded history (600 BCE) in his book in Suśrutasaṃhitā. OSF is Areca nut (Areca Catechu Linn.) habit associated disease and more prevalent in countries where the use of this nut is high. In Southeast Asian countries it is widely used due to their high cultural beliefs. The pathogenesis of this age old irreversible disease is very complex, that none of the treatment modalities till date has provided satisfactory results. In this article, insight to Areca nut native, cultivation and cultural aspects, the psychology behind its use in various cultures and review of current medical literature is attempted to trace back the history of OSF.