Symptoms & Causes of Oral Lichen Planus

What is Oral lichen planus?

Lichen planus is a chronic (ongoing) inflammatory disease that affects the mucous membranes, causing white patches, redness, and swelling inside your mouth. 

What causes oral lichen planus

Oral lichen planus is caused by immune system dysfunction. The exact trigger that causes the immune system to attack the structures involved is still in question. Some theories described lichen planus as a disorder caused by the autoimmune attack in the absence of other autoimmune disorders. In contrast, some theories point out that lichen planus is a symptom of another autoimmune disease. 

Irrespective of the theories surrounding the exact trigger of this disorder, lichen planus is not a contagious condition. It is a disorder that presents as rashes and sore on skin, hair, nails, mucous membranes such as the oral cavity, nose, ears, eyes, pharynx, esophagus, anus, larynx, genitals and the peritoneum.

Symptoms of oral lichen planus

Oral lichen planus is the form that affects the mucous membrane in the mouth. It manifests as: 

  • Swollen tongue with white patches on both sides of the cheeks.
  • Open sores on the gums and inner areas of the lips that bleed when brushing and feels like the lips are on fire when chewing, drinking, or talking.
  • Spiderweb-like raised lesions in the mouth
  • Tender, swollen red patches in the soft tissues of the upper and lower lips that are painful
  • Burning discomfort and painful sensation when talking or moving the mouth.

The exact trigger of oral lichen planus is unclear, but those with certain disorders are more prone to being affected.

Risk Factors Of Oral Lichen Planus include:

  • Previous oral injury
  • Systemic lupus erythematosus
  • Oral infection such as dental abscess
  • Allergic reaction to certain foods or oral exposure to certain substances.
  • Being a woman (it is more common in middle-aged women).
  • Immunosuppressive states such as being on immunosuppressive drugs or diseases that suppress the immune system such as HIV/AIDs.
  • Certain medications such as Antihypertensive, antidepressants, NSAIDs, or oral hypoglycemic medications.
  • Dental work (reacting dental appliances)
  • Hepatitis C

How is Oral lichen planus diagnosed?

Diagnosis is confirmed in the presence of positive findings in any of these categories:

  • History of dental work
  • History of autoimmune diseases
  • Presence of typical Lichen planus lesions on other parts of the body.
  • Physical examination of lesions is in-line with typical lichen planus lesions.
  • Blood analysis
  • Patch test 
  • Biopsy: tissue taken from the mouth is viewed under the microscope (biopsy).

How is Oral lichen planus treated?

Unfortunately, Oral lichen planus can’t be cured, although it can be managed with the following options:

  • Improve oral hygiene by using mild toothpaste and a soft toothbrush to brush your teeth always. 
  • Topical corticosteroids (Dexamethasone, Betamethasone, and Triamcinolone) are the first-line management for Oral Lichen Planus.
  • Steroid lozenges or mouthwashes if the sore inside the mouth become painful.
  • Pain relievers
  • Systemic steroids are used in severe cases of Oral Lichen Planus.
  • Reduce stressful situations: stress worsen symptoms in some cases, so learning stress management techniques and avoiding stressful situations is recommended.

Complications Of Oral Lichen Planus

Untreated Oral Lichen Planus can lead to:

  • Oral cancer
  • Loss of appetite due to fear of pain when chewing or drinking
  • This can eventually lead to weight loss and malnutrition
  • Depression
  • Increase the risk of oral thrush
  • Fatigue

For more information about oral lichen planus, you should talk to your physician.