Oral Lichen Planus
Exodontia.Info
What is Lichen Planus?

Lichen Planus is a long-term disease, which can affect the
skin and mouth and, in some cases, the genital area.

It affects 1 - 2% of men and women in the UK and is more
common in people over 40-years old.

It is not a cancer or an infectious disease that can be
passed on and it does not run in families.

What is the Cause of Lichen Planus?

The cause of Lichen Planus is not known but it is probably
related to the immune system where cells that normally
fight off germs attack normal parts of the body.

Certain drugs used in the treatment of high blood pressure,
arthritis and diabetes may cause
Lichen Planus-like lesions.

Also, where the cheeks or tongue have been lying against
teeth have amalgam restorations,
Lichen Planus-like
lesions may occur.  Emotional stress and spicy foods or
citrus fruits can often cause symptoms to worsen.

It is not thought to be infectious.

What are the signs and symptoms?

Lichen Planus appears in a wide variety of ways and can
cause pain, burning and/or soreness in the mouth.

It can often go unnoticed and may only be recognised by a
dentist or hygienist during a routine examination.  White,
net-like lines or white patches are usually seen on the inside
of both cheeks and can also appear on the tongue and
gums.  These do not usually cause any discomfort.

In some cases, red patches, ulcers or blisters appear which
can be painful.  The gums can also become thin, red and
shiny in appearance and it may hurt to brush your teeth.  
About one third of people also get a purple, itchy rash with
raised dots on the skin, especially on the wrists and shins.  
Very rarely, changes can be seen in the genital area, hair
and nails.
Photos of Oral Lichen Planus affecting the tongue &
buccal mucosae
How Is It Diagnosed?

Blood tests and a biopsy of an affected area may be
required.

How is it treated?

As long as there is no pain, treatment is not usually
necessary.  In all cases, it is important to keep your
mouth clean, as it stops the
Lichen Planus from getting
infected.

There are many different treatments available for
treating the condition if it is causing a problem.

The usual treatment is
steroid medication and / or
antiseptic / pain-relieving mouthwashes.  These are not
absorbed into the body as they only work on the area
they are applied to and therefore cause no side effects.

It may be an idea to try to identify factors that make the
problem worse, e.g. stress, spicy food such as chillies,
citrus fruit and strongly-flavoured toothpastes (containing
cinnamonaldehyde).

In severe cases, the hospital doctor will prescribe some
stronger medication.

Prognosis.

Most
lichen planus is benign.  There are some forms of
lichen planus that may rarely, after years, lead to a
tumour; in this case, have yourself checked regularly if
the specialist advises.


Useful Websites:

International Lichen Planus Support Group Web

American Academy of Dermatology


Useful Articles:

Eastman Dental Institute Oral Medicine Clinic.  Oral
Lichen Planus Patient Information Sheet.  1999.

Dental Update 2002.  Oral Lichenoid Drug Eruptions:
Their Recognition and Management.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod
2004.  Healing of oral lichenoid lesions after replacing
amalgam restorations: A systematic review.

Oral Surgery, Oral Medicine, Oral Pathology, Oral
Radiology & Endodontology 2005.  Current
controversies in oral lichen planus: Report of an
international consensus meeting. Part 1. Viral infections
and etiopathogenesis.

Oral Surgery, Oral Medicine, Oral Pathology, Oral
Radiology & Endodontology 2005.  Current
controversies in oral lichen planus: Report of an
international consensus meeting. Part 2. Clinical
management and Malignant Transformation.

Oral Lichenoid Lesions - More than Mercury
Last Updated 18th August 2010