THE BLOG
11/19/2010 08:07 am ET Updated May 25, 2011

Mouth Health: What Is Oral Lichen Planus?

For today's article, I want to discuss Erosive Lichen Planus, and how it can affect one's oral health.

To begin, Erosive Lichen Planus is a chronic disease that can affect the skin and/or mouth areas. In fact, it typically attacks the mucocutaneous areas (the "mucous membrane" areas of the body), which means that the mouth and genitals are the most common places the condition is found. The disease has nothing to do with Lichens or the like -- it gets its name from the appearance of the lesions it causes. In overall numbers, the condition typically affects 1-2 percent of all adults.

Obviously, since I'm a NYC Cosmetic Dentist, we'll concentrate on the oral aspect (Oral Lichen Planus).

Appearance And Other Symptoms
In general terms, the condition presents itself in the form of lesions, sores, or rashes that affect the mouth, tongue and even the lips. You may see lacey white patches, red swollen tissue or even open sores. The lesions may be painful, and even have a burning sensation.

The above can affect any area in one's mouth. Inside the cheeks is the most common place to find Oral Lichen Planus, but it can be found in other places as well: the tongue, lips, gums and hard palate. Anywhere in or around one's mouth. Even the throat and/or esophagus can be affected.

Besides the obvious "appearance" symptoms, there are other indicators of the condition. These include a metallic taste in the mouth, loss of taste, dry mouth, difficulty swallowing, sensitivity to hot/spicy foods and even bleeding when you brush your teeth.

Now, I've just described symptoms that millions of people have. However, like I stated in the beginning, this condition affects about 1-2 percent of the adult population, so most people that have bleeding gums or dry mouth probably do not have Oral Lichen Planus (but still, if it's chronic, get checked.)

Causes
Here's the kicker with Oral Lichen Planus: We really don't know -- definitively -- what causes it. I realize that's not very helpful to anyone looking for information on this disease, but that's the plain truth.

However, that said, there are a few things we DO know about it:
  • It is not contagious. You cannot catch it from anyone, nor can you give it to someone else.
  • It is definitely an immune system disorder (specifically, white blood cells called T lymphocytes). In fact, Oral Lichen Planus occurs when the immune system attacks the cells of oral mucous membranes without obvious reason. Why this happens is unclear.
  • While it can occur at any age, it usually affects adults aged 45-60, and affects twice as many women as men.
  • The research is still ongoing, but here are a few other factors that can/might trigger Oral Lichen Planus (I want to warn you -- this is a big, common list of possible triggers): Hepatitis C infection and B Vaccination; some flu vaccines; certain anti-inflammatory drugs, such as ibuprofen and naproxen (this means your Advils, Motrins, and Aleves); other medications for heart disease, arthritis and high blood pressure; the "typical" oral triggers such as alcohol, tobacco, poor dental work and mouth trauma; and (of course) our old friend stress.

Sigh ... I know what you are thinking after reading that -- "everything" causes Oral Lichen Planus. And right now, that's pretty much the stage we are in. So let's just say that good oral health is very likely a key component in preventing the condition.

Also, you may realize after reading the above, that many of the symptoms and possible causes of Oral Lichen Planus are the same as oral cancer. This brings me to one last point: In a small number of cases (1-3 percent), Oral Lichen Planus has been a precursor to oral cancer.

Treatment
In many cases, Oral Lichen Planus is a chronic, ongoing condition. However, it can usually be treated to the extent that it's no more troublesome than an occasional cold sore. And in many cases, it disappears altogether in a few months.

Mild cases may need nothing more than a dentist visit and maybe some special mouthwash. Certain ointments and creams may reduce swelling and numb pain. Oral medications that treat immune system response can also help.

Your dentist or doctor can also help in narrowing down what is causing the condition in the first place. It may be that you need to modify your medication, or quit smoking (which is a good idea regardless of oral health, by the way). Good dialog is always important here -- try and write down everything that could have caused the condition. Have you started any new meds? Received new dental work? Any infections? Etc? Any one of these could have brought the condition forth.

As with any condition, Oral Lichen Planus will respond best with early detection, so see your dentist if you experience any of the following:
  • Mouth sores that don't heal, chronic bleeding or mouth pain.
  • Red or white patches in your mouth.
  • Lesions/sores on your genitals, scalp or nails (this is where Erosive Lichen Planus typically also strikes, and if it affects those areas, Oral Lichen Planus may not be far behind.)

In closing, I hope you learned a little bit about this condition. Again, the true cause is unknown, so the more people that become aware of it, the more people might get diagnosed early, and the better the chances for the medical profession to narrow down a cause and cure.

Until next time, keep smiling.