There are many different types of mouth sores that can develop around or in the mouth.
Some are painful, some are unsightly, and some may be a sign of something more serious.
Oral lichen planus is a non-infectious inflammatory condition that affects the membranes inside our mouth. It is a variation of the skin condition that is known as lichen planus.
For some patients, the symptoms are mild, but for others, painful sores and red inflamed tissue cause discomfort.
It is a long-lasting disease, which can happen to anyone, and it doesn’t go away easily. Although, you can keep it under control.
Oral lichen planus affects approximately 2% of the population. Women, over the age of 50 years, are the most commonly affected.
It is not a contagious condition and can’t spread to another person. Let’s find out more about this condition and how you can manage it.
What is Oral Lichen Planus?
Lichen planus is an itchy skin rash that is caused by an immune response. It can occur anywhere on your skin.
In the case of oral lichen planus, the mucous membranes inside your mouth are the only affected part.
Oral lichen planus presents symptoms different from other cases of lichen planus.
Symptoms of Oral lichen planus
Symptoms for oral lichen planus may come on slowly or start all at once. You may begin with dryness or a metallic, burning taste in your mouth.
Lesions from oral lichen planus can be present in these areas –
- Inside of your cheeks (most common location)
- Inner tissues of your lips
The lesions appear as white patches on your tongue, cheeks, and gums. It can appear as either white, lacy, raised patches of tissue that resemble spider webs or tender, swollen patches that are bright red.
The lesion often appears bright red due to the loss of the top layer of mucosa in the affected area.
You may experience pain and discomfort when eating and drinking, particularly with extremes of temperatures, acidic, coarse, or spicy foods.
The white lesions of oral lichen planus can appear as- or develop into- open sores (ulceration). In such cases, your symptoms could include:
- Burning or stinging pain in the affected area
- Pain or discomfort when speaking, eating or drinking
- Increased sensitivity to acidic, spicy, coarsely textured, or hot foods
- Inflammation of your gums, including bleeding when brushing your teeth
What causes Oral Lichen Planus?
The exact cause for oral lichen planus is not known. Certain factors can trigger an outbreak or a worsening of the symptoms.
Some theories point to oral lichen planus as being an autoimmune disorder of its own, while others think it could be a symptom of another autoimmune disorder.
The following factors can cause you to develop oral lichen planus or be triggers in people who already have the condition-
- Having an autoimmune disorder
- Sustaining an injury to the mouth
- Having an oral infection
- Taking certain medications
- Having an allergic reaction to something that came in contact with the mouth, like food or dental appliances
Though stress isn’t a known cause, emotional stress can increase the symptoms. This condition is also linked with diabetes and hepatitis C. (2)
How is Oral lichen planus diagnosed?
An oral surgeon, dentist, or dermatologist can diagnose oral lichen planus. The medical professional will ask for a thorough medical history, including how long you have been experiencing symptoms and any medications you are taking.
Then they will perform a visual and physical examination to reach an initial diagnosis.
If they’re unsure of the diagnosis, they’ll likely order a biopsy of one or more lesions to collect samples of tissue.
A laboratory will analyze the samples using a microscope to help with a diagnosis for oral lichen planus.
Treatment for Oral Lichen Planus
There is no known cure for oral lichen planus. As it is a chronic condition, it can only be managed.
The treatment focuses on resolving the symptoms and minimizing the lesions as much as possible. Treatment options include –
- Topical corticosteroids, in the form of a gel, ointment or mouthwash applied directly to the affected area. (3)
- Injection corticosteroids applied directly to the lesion.
- Oral corticosteroids, which can only be taken for a short time.
- Immune response medications.
You may also need to make specific lifestyle changes to help manage oral lichen planus. These include –
- Using a mild toothpaste and toothbrush.
- Eating well and getting plenty of nutrients through foods like fruits, vegetables, nuts, and lean protein.
- Getting plenty of exercises.
- Reducing stress.
- Avoid spicy and acidic foods and beverages.
- Have your dentist polish sharp teeth or replace damaged fillings or crowns.
- See your dentist twice a year for a cleaning and check-up.
Oral lichen planus is a chronic condition. The symptoms can be managed, but the condition can’t be cured.
It is essential to maintain regular appointments with your health care provider or dentist to help you manage symptoms and adjust your treatment plan as needed.
Also, your dentist will also look for any potential signs of mouth cancer.