An epidemiological survey was done among the panmasala chewers in North Bengal tea garden and Kolkata and suburbs. A total no of 1514 subjects who had attended in different camps with panmasala/gutkha chewing habit over a period of 2 years time were interviewed and clinically examined for mucosal lesion. The purpose of our present study was to evaluate the occurrence of OSF among the panmasala chewers in west Bengal and identification of risk genotypes of NQO1 C609T, LOX G473A and XRCC5 VNTRs in susceptibility to OSF. An epidemiological survey to examine the prevalence was necessary to understand the relation of areca chewing habit and oral submucous fibrosis. This book will help researchers to have an idea about the prevalence of oral submucous fibrosis and role of genetic polymorphisms in increasing the risk of the disease.