Often a breakthrough link in the understanding of the aetiopathogenesis of a hitherto common pathology that has been evading the medical community may not come from the hi-tech labs of the developed world, but from the intelligent investigations from a modest laboratory of a developing nation. Researchers from a far-flung district in Southern India have investigated the concentration of copper ions in drinking water and attempted to determine whether copper has a role in the pathogenesis of oral submucous fibrosis (OSMF). They studied 50 patients with clinically and histologically diagnosed OSMF from the Yadgir district of Karnataka in India. Fifty healthy people, matched for age and sex, were used as controls. In both groups concentrations of copper ions in serum, saliva, and home drinking water were measured using atomic absorption spectroscopy and intelligent nephelometry technology. Serum ceruloplasmin concentrations were also estimated in both groups. The studies showed that the mean (SD) concentration of copper in the home drinking water of patients with OSMF was significantly higher (764.3 (445.9)μmol/L) than in the controls (305.7 (318.5)μmol/L) (P<0.001). Patients with OSMF also had a significantly higher copper concentration in serum and saliva, and serum ceruloplasmin than controls (P<0.001). The authors claim that, for the first time, a positive association between copper concentrations in home drinking water and OSMF has been established. It raises the possibility that increased copper in drinking water contributes to the development of OSMF, and adds to that ingested when areca nut is chewed.