OLP facts

  • It is a disease of unknown cause, but it may sometimes represent an allergic reaction.
  • It affects about 1% – 2% of the general population.
  • It occurs in women more than men.
  • It occurs more often in individuals past the age of 50.
  • It can occur on the skin or genitalia and in the oral cavity.
  • In the mouth it can occur in six different forms, ranging from lacy-white streaks, to white plaques, to eroded ulcers.
  • The white lesions of lichen planus are usually painless.
  • The eroded lesions usually burn and can be quite sore.
  • The gums are often affected, causing the surface of the gum tissue to peel off and leaving the gums red and raw.
  • Sometimes it appears to represent a reaction to medications, some filling materials, dental hygiene products, chewing gum, candy or other substances that touch mouth tissue.
  • Stress may play a role in outbreak of the sores.
  • Lichen planus may come and go, but it often can remain present for years if not treated.

What to do if you think you may have oral lichen planus

  1. See your dentist and obtain a biopsy if indicated. He or she can do this for you or refer you to someone who can.
  2. Keep notes about the condition. When did it start? What medications are you taking? Did it start about the time you began a new medication? Did it start when you began using a new toothpaste or mouthrinse? Did you have dental work done shortly before it started? Does it tend to come and go?
  3. Evaluate your personal and work situation regarding stress. If you are under stress are there steps you can take to reduce it?

What to do if you have lichen planus

  • Talk with your dentist or physician about treatment. Strong topical corticosteroids are often quite beneficial.
  • Ask your dentist or physician to be observant for signs of oral yeast infection. Sometimes the use of topical corticosteroids will change the mouth environment enough for that to become a problem. Occasionally one needs an anti-yeast medication as a preventive while using strong topical or systemic corticosteroids.
  • Maintain good oral hygiene but be careful about brushing too hard. Sometimes you can brush away the surface of the gum tissue where you have sores. Electric or sonic toothbrushes may be a bit too irritating to use until your gums are free of lichen planus sores.
  • While your mouth is too sore to brush well, consider an effective anti-plaque mouthrinse which is low in alcohol and which does not burn when you use it. Be careful with this there are a lot of mouth rinses which don’t burn but which also don’t do much to reduce plaque. The best ones for someone with a sore mouth contain a substance named “chlorhexidine,” but a prescription is required to obtain them. Unfortunately, they contain a low percentage of alcohol. If the mouthrinse burns when you use it STOP using it even if you have to do without a mouthrinse.
  • Avoid dental hygiene products and foods that burn in your mouth. Do not use alcoholic beverages or mouth rinses with a high alcohol content. Do not use products which contain hydrogen peroxide.
  • While your mouth is sore, you should have your teeth professionally cleaned fairly often, usually about every two months. Sometimes that will make your gums worse for a few days, but in the long run it will help keep them as healthy as possible. If your gums are affected with lichen planus, it may be better to ask your dentist or dental hygienist to avoid using some of the newer professional tooth cleaning devices (ultrasonic or sonic scalers) because they vibrate and may disrupt the surface tissue of your sore gums.
  • Once you have lichen planus, you should be periodically examined by your dentist or physician so they can keep an eye on you and detect any other mouth changes that may occur.
  • If your lichen planus does not improve with topical medications and if you’re taking medications for a chronic illness or disorder, ask your physician to consider an alternative medication as a trial to see if your mouth lesions are drug-induced.
  • Talk with others who have lichen planus and find out about things which may work for them.