What are the symptoms of oral lichen planus?

Oral lichen planus is a chronic inflammatory condition that affects the mucous membranes inside the mouth. The symptoms of oral lichen planus can vary in severity and may include:

1. Erosive lesions: These are painful, eroded areas or ulcers that may appear on the inside of the cheeks, gums, tongue, or other areas of the mouth. The erosions can be surrounded by a white, lacy border.
2. Reticular lesions: These appear as white, lacy, or web-like patterns on the inside of the cheeks, gums, or tongue. These lesions may be asymptomatic or cause mild discomfort.
3. Plaque-like lesions: These are raised, white or red patches that can appear on the inside of the cheeks, gums, or tongue.
4. Oral discomfort or pain: Many individuals with oral lichen planus experience a burning sensation, soreness, or pain in the affected areas of the mouth, making it difficult to eat or drink certain foods or beverages.
5. Oral sensitivity: The affected areas may become sensitive or irritated, especially when exposed to hot, spicy, or acidic foods and beverages.
6. Gum inflammation (desquamative gingivitis): In some cases, oral lichen planus can cause inflammation, redness, and peeling of the gums (desquamative gingivitis).
7. Altered taste sensation: Some individuals may experience a metallic or altered taste sensation due to the oral lesions.
8. Difficulty swallowing: In severe cases, the lesions or erosions can make swallowing painful or difficult.

It’s important to note that oral lichen planus can occur in conjunction with lichen planus affecting other areas of the body, such as the skin, scalp, or nails. Additionally, the symptoms can come and go, with periods of remission and flare-ups.

If you experience any persistent or concerning oral lesions, discomfort, or changes in your mouth, it’s crucial to seek medical attention from a dentist or an oral medicine specialist for proper evaluation and treatment. Prompt diagnosis and management can help alleviate symptoms and prevent potential complications.

What are the causes of oral lichen planus?

The exact cause of oral lichen planus is not fully understood, but it is believed to be an autoimmune disorder triggered by various factors. Here are some of the potential causes and risk factors associated with oral lichen planus:

1. Autoimmune response: Oral lichen planus is thought to be an autoimmune condition, where the body’s immune system mistakenly attacks the cells lining the oral mucosa (the inner lining of the mouth).
2. Genetic predisposition: Some individuals may have a genetic predisposition or inherited tendency to develop oral lichen planus, but specific genes have not been identified.
3. Medications: Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), antimalarials, beta-blockers, and some medications used to treat heart disease, high blood pressure, or arthritis, have been linked to the development of oral lichen planus in some cases.
4. Dental materials: There is some evidence suggesting that certain dental materials, such as amalgam fillings or other metal-based restorations, may trigger oral lichen planus in susceptible individuals.
5. Stress: Psychological stress has been proposed as a potential trigger or exacerbating factor for oral lichen planus, although the exact mechanism is not well understood.
6. Infections: Some viral or bacterial infections, such as hepatitis C virus (HCV) infection, have been associated with an increased risk of developing oral lichen planus.
7. Trauma: Chronic trauma or injury to the oral mucosa, such as from ill-fitting dentures or rough dental work, may contribute to the development of oral lichen planus lesions in some cases.
8. Allergies or sensitivities: Certain foods, additives, or chemicals may trigger or worsen oral lichen planus lesions in some individuals due to an allergic or sensitivity reaction.

It’s important to note that in many cases, the exact cause of oral lichen planus remains unknown, and it may be a combination of various factors that contribute to the development of the condition. Identifying and addressing potential triggers or underlying conditions can help manage and reduce the symptoms of oral lichen planus.

What is the treatment for oral lichen planus?

The treatment for oral lichen planus aims to alleviate symptoms and manage the condition. The specific treatment approach may vary depending on the severity and location of the lesions, as well as the individual’s overall health. Here are some common treatment options for oral lichen planus:

1. Topical corticosteroids: High-potency corticosteroid ointments, gels, or mouth rinses are often the first line of treatment for symptomatic oral lichen planus lesions. These medications help reduce inflammation and alleviate pain and discomfort.
2. Systemic corticosteroids: In cases of widespread or severe oral lesions, oral corticosteroid medications (such as prednisone) may be prescribed for short-term use to help control the inflammation.
3. Topical immunomodulators: Medications like tacrolimus ointment or pimecrolimus cream, which modulate the immune system’s response, may be prescribed for erosive or severe oral lichen planus lesions.
4. Oral rinses: Oral rinses containing anti-inflammatory agents, such as dexamethasone or triamcinolone, can help soothe and protect the affected areas of the mouth.
5. Pain management: Over-the-counter or prescription pain medications, such as acetaminophen or low-dose opioids, may be recommended to alleviate severe pain or discomfort associated with oral lesions.
6. Phototherapy: In some cases, ultraviolet (UV) light therapy, such as narrow-band UVB or PUVA (psoralen plus UVA), may be used to help manage oral lichen planus lesions.
7. Removal of dental materials: If a specific dental material is suspected to be the trigger, removing or replacing the material may be recommended.
8. Nutritional supplements: Supplements like vitamin A, vitamin C, and vitamin E, or omega-3 fatty acids, may be suggested to support the healing process and reduce inflammation.
9. Avoiding triggers: Identifying and avoiding potential triggers, such as certain foods, medications, or habits (e.g., quitting smoking), can help prevent flare-ups or worsening of symptoms.
10. Monitoring for complications: Regular dental check-ups and monitoring for any potential complications, such as oral cancer, are essential for individuals with oral lichen planus.

It’s important to note that oral lichen planus is a chronic condition, and treatment may need to be adjusted or combined with different approaches to manage symptoms effectively. Close collaboration with a dentist, oral medicine specialist, or dermatologist is recommended for optimal management of oral lichen planus.