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Lichen planus is a long-lasting disease, which can affect the mouth and sometimes other areas of the body. When it appears in your mouth it is called 'oral lichen planus'. It can appear on its own or as part of a disease affecting other parts of your body. Oral lichen planus usually happens from middle age onwards, and more women get it than men.
Lichen planus shows in many different ways. The most common signs are white patches on the lining of your mouth (usually your cheeks, tongue and gums). These don't usually hurt, but sometimes there can be redness, ulcers or, very rarely, blistering as well as the white patches. If so, you may find it painful to eat hot or spicy foods.
We do not know the cause of lichen planus in most patients.
It may be a sign of a slight weakness in the body's immune (defence) system, but patients with lichen planus don't usually have any other problems. Occasionally it can be caused by a reaction to medicines such as some painkillers, diabetic treatments, drugs for high blood pressure, beta-blockers, gold, or penicillamine. Oral lichen planus does not seem to be caused by an infection, and it doesn't run in families. Emotional stress, spicy food or citrus fruits can often cause the symptoms to get worse.
Usually it will be diagnosed after a careful examination by a specialist. The appearance and symptoms of oral lichen planus can be like those of some other disorders, so a 'biopsy' is usually needed to be sure about the diagnosis. A biopsy is a very simple procedure, done under a local anaesthetic, where a small piece of tissue is removed from the mouth. The area usually heals within 7 to 10 days.
Usually oral lichen planus only needs to be treated when there are painful symptoms. Sometimes patients with white patches that are not painful complain of a slight roughness of the lining of the mouth. But this usually does not need any treatment. When oral lichen planus does need treating, it is usually done by putting a corticosteroid cream on the area. Some areas may need other treatments, such as immunosuppressants applied to the area. Very rarely you might need to take a corticosteroid or some other, similar, tablets.
Follow any advice your dental team may give you. This may include avoiding things that make the condition worse, such as spicy foods and things you may be allergic to. Your dentist may also refer you to your doctor or a specialist for further investigations.
Usually oral lichen planus never goes away. Patients will usually continue to have white patches on the lining of the mouth. Treatment will lessen the pain, although it is not usually possible to tell beforehand when the condition will become painful.
There may be some connection between oral lichen planus and cancer of the mouth. Around 1 to 3 percent of patients who have had lichen planus for a long time may go on to develop mouth cancer. The exact connection between oral lichen planus and cancer is not certain. Only a very few patients with oral lichen planus ever develop cancer.
As the cause is usually not known it is impossible to stop oral lichen planus happening. To avoid the risk of serious disease of the lining of your mouth:
Whether you have oral lichen planus or not, you should clean your teeth last thing at night and at least one other time during the day with a fluoride toothpaste. You should also have your teeth and gums checked regularly by a dentist so that any changes in the lining of your mouth can easily be spotted.
If you need free and impartial dental advice please do not hesitate to contact our Dental Helpline or call 01788 539780 (local rate call in the UK).