Oral Lichen Planus

Oral lichen planus is an autoimmune inflammatory condition affecting the mucous membranes of the mouth.

Incidence; Causes and Development

The condition is most common among middle-aged women, but anyone can be affected.

As with other autoimmune diseases, oral lichen planus occurs when your immune system attacks your body – in this case, the oral mucous membranes.  The cause, however, remains unknown.

Known triggers include:

• Hepatitis C infection and other liver diseases
• Hepatitis B vaccination
• Certain flu vaccines
• Allergens such as foods or dental restoration materials
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Certain heart disease, blood pressure, or arthritis medications

The condition can be exacerbated by tobacco, alcohol, poor dental work, poorly-fitting dentures, biting the kips or cheeks, dental plaque build-up, or stress.

Signs and Symptoms

Oral lichen planus may appear as white, raised, 'lacy' patches, or red, swollen, tender tissues, or as open sores.  These may be accompanied by burning, pain or other discomfort.  Bleeding and irritation may occur with tooth brushing.

The most common location is inside the cheeks, but it can also affect the gums, tongue, inner lips, throat and esophagus.

Treatment and Prevention

Treatments that suppress the immune system may improve the condition, but in general oral lichen planus is a chronic condition that is difficult to manage.

Patients with no discomfort and only white, lacy lesions may not require treatment.

If oral lichen planus is suspected as being triggered by a pharmaceutical drug, hepatitis C, allergens or stress, then the trigger(s) should be addressed.

Prognosis; Complications

Oral lichen planus is usually an ongoing (chronic) condition.

People with oral lichen planus may also develop lichen planus lesions on the skin, genitals or other parts of the body.  It may also increase the risk of oral cancers such as squamous cell carcinoma.