Oral Lichen Planus

Oral Lichen Planus: Overview

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

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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:

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.

Signs, symptoms & indicators of Oral Lichen Planus:

Symptoms - Food - General

Difficulty swallowing

Lichen planus lesions in the throat or esophagus may result in esophageal narrowing or the formation of tight, ring-like bands in the esophagus that can make swallowing difficult.

Symptoms - Head - Mouth/Oral

(Minor/significant) mouth sores

About half of those who get lichen planus also develop mouth sores.

Metallic taste in mouth

A metallic taste or a reduction in taste sensation may be present if the tongue is affected.

(Much) reduced sense of taste

If the tongue is affected, this may result in a blunted taste sensation.

Counter-indicators
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Conditions that suggest Oral Lichen Planus:

Dental

Recommendations for Oral Lichen Planus:

Diet

Spicy Foods Avoidance

Sensitivity of the mouth to hot or spicy foods can result from lichen planus.  Eliminate spicy or acidic foods if they worsen symptoms.

Drug

Corticosteroids

Corticosteroids (topical, oral or by injection) may reduce the inflammation caused by oral lichen planus.

Habits

Personal Hygiene Changes

Good oral hygiene keeps the mouth clean, reduces inflammation and helps prevent infection.

Vitamins

Vitamin A

Retinoids – synthetic versions of vitamin A – can be applied as a topical ointment or taken orally.  This doesn't cause the same side-effects as corticosteroids, but may irritate the mucous membranes of the mouth.

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