Oral Lichen Planus: Symptoms, Causes, and Treatments

Do you have white patches in your mouth? What about redness and swelling? You may have oral lichen planus. It’s a long-lasting disease that affects your mouth. It doesn't go away, but you can keep it under control.

Anybody can get it. Women are more likely to have it than men. It's most common in people older than 40. But kids and young adults can also get it.

What Causes It?

Doctors aren't sure what causes oral lichen planus. It may run in your family. And it could be linked to your immune system. Most of the time your immune cells keep you safe by attacking bacteria and viruses. With oral lichen planus, some doctors believe those cells get confused and attack the lining of your mouth.

Other possible triggers include medicines like painkillers, high blood pressure treatments, diabetes drugs, and malaria medications.

It may also be a reaction to metal, such as dental fillings. It could be triggered by other mouth problems such as having a rough crown or a habit of biting your cheeks or tongue.

There's also a chance that it’s linked to hepatitis C. Many people infected with the virus get it.

What is certain is that oral lichen planus isn't contagious. You can't pass it to anyone else and you didn't catch it from someone.

What Are the Symptoms?

Symptoms can come on slowly or start all at once. You may start out with dryness or a metallic, burning taste in your mouth. Then you’ll see white patches on your tongue, cheeks, and gums. They can be tiny dots or lines that make a lace-like pattern. You may also have redness and swelling. Sometimes, there's peeling or blistering.

These sores can be burning and painful. They’ll likely hurt the most when you eat or drink foods that are spicy, salty, acidic (orange juice, tomatoes), or alcoholic. Crispy treats and drinks with caffeine can also cause problems.

Your doctor can diagnose oral lichen planus by taking a small piece of skin from inside your mouth. This is called a biopsy. He’ll run tests on it in the lab to see what the problem is. You may also need blood tests to rule out other conditions.

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How Is It Treated?

If you only feel a slight roughness in your mouth, you may not need treatment. If you’re in pain or have sores, your doctor may suggest a corticosteroid cream. In rare cases, he might prescribe steroid pills.

What Can You Do?

Watch what you eat and drink. Certain foods and drinks -- especially spicy or citrus ones -- can make your symptoms worse. Hot or cold foods and drinks can also make you more uncomfortable.

Stress can also make things worse.

Get rid of any problems that could trigger oral lichen planus or make it worse:

  • Have your dentist polish sharp teeth or replace damaged fillings or crowns.
  • Talk to your doctor about changing medications that may be to blame.
  • Brush twice a day and floss daily.
  • See your dentist twice a year for a cleaning and check-up.
  • Use a mild toothpaste and a soft toothbrush.

You also need to keep track of your symptoms and tell your doctor about any changes in your mouth. There's a slight chance that oral lichen planus can lead to oral cancer. Make sure to get a screening for oral cancer every 6 to 12 months.

It's also important to enjoy a diet rich in fruit and vegetables. If you smoke, quit. Don't drink large amounts of alcohol. See your doctor regularly to look for any changes in your mouth.

WebMD Medical Reference Reviewed by Michael Friedman, DDS on January 17, 2018

Sources

SOURCES:

American Academy of Dermatology: "Lichen planus."

American Academy of Oral & Maxillofacial Pathology: "Lichen Planus."

British Dental Health Foundation: "Lichen planus."

Medscape: "Oral Lichen Planus."

National Association for Rare Disorders: "Lichen Planus."

The American Academy of Oral Medicine: "Oral Lichen Planus."

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