Lichen planus is an acute, subacute or chronic disease of skin and mucus membrane. It is characterized by purplish or violaceous, flat topped itchy papules, occurring mostly in hands, legs and in mouth. The name lichen attributes to purplish lichens that grow on trees in the hills.
In mouth, lichen planus may present itself as white streak on the tongue, inside the cheeks, and on the gums. It may also appear as an open ulcer. Person having oral lichen may feel burning in his mouth on eating and drinking, but sometimes it is painless.The reason for its occurrence is not known however there are several triggering factors suspected.
Lichen planus in mouth is usually chronic in nature. Person having lichen planus in mouth may also have lichen in other parts of skin and genitals. Treatment may reduce the severity of pain, but the condition may take long time to heal. One should always keep a regular follow up with his physician if he has oral lichen as it is prone to oral cancer in some cases.
Causes Of Lichen Planus In Mouth
There is no exact reason understood for development of lichen planus in mouth.It is an inflammatory change in the mouth which is controlled by a specific lymphocyte called T lymphocyte. Lymphocytes are a type of white blood cells. Lichen planus in mouth generally affects middle aged individuals with an affinity towards women. There are several reasons which are suspected to trigger this inflammatory response in mouth.
- Liver diseases such as hepatitis C.
- Certain vaccines such as hepatitis and flu vaccines are blamed for development of lichen lesions in mouth.
- Allergy: Allergies to foods, dental implants or dental filing which contain mercury are also possible triggering factors.
- Certain NSAID’s drugs such as Ibuprofen, naproxen is also suspected to trigger oral lichen planus.
- Tobacco chewing.
- Poor oral hygiene.
- Psychogenic stress.
Symptoms Of Lichen Planus In Mouth
Many times lichen planus in mouth is not detected and it is only found while a doctor examines the patient’s mouth.
- The lesion appears as a white raised patch or white streaks inside the mouth on tongue, in the cheek or gums. In some cases the lesion can appear in the throat or in the esophagus.
- Burning pain and discomfort in the mouth are two issues that trouble the patient, especially if lesion is inflamed, red and if it is an open ulcer. However, if the patch is white it is painless, unless it is present under or on the tongue.
- There is constant metallic taste in the mouth when the lesion is present on the tongue surface. Patient may feel extreme burning sensation when eating hot and spicy food.
- If the lesion is in throat and esophagus, patient finds difficulty in swallowing.
- If the lacy network or dead white spots appear on gums, brushing may lead to bleeding and irritation.
Oral Lichen Planus Treatment
Lichen planus in mouth is a chronic condition and it is difficult to treat it completely. The aim is to reduce the severity of the lesions and lessen the pain and discomfort if any.
- Doctors generally recommend the patient to apply topical corticosteroids. However, it should be applied for short interval as there is risk of oral thrush and various other disorders.
- Other topical preparations consists of retinoids, nonsteroidal ointments etc.
- Patient may be advised by the physician to stop a drug which he is taking for some other disease if that drug is responsible for provoking the lesion.
- Certain allergens or dental materials which are responsible for it may have to be abandoned.
- As stress is also one of the factors, patient is advised to reduce and manage a stressful situation. Yoga, meditation is useful in reducing stress.
- Patient needs to follow good oral hygiene. He should avoid spicy and acidic foods, which may make the condition worse.