Oral Lichen Planus: Working With Your Dentist To Minimise Pain And Complications

Despite the enormous leaps and bounds that oral and dental medical science have made in recent years, there are still some conditions which can affect the mouth and cannot be cured. Lichen planus, a mysterious illness that can affect various parts of the body including the mouth, is one of them. However, all that scientific progress wasn't for nothing, and although a case of oral lichen planus cannot be cured (yet), your dentist can offer you a range of palliative treatments to minimise the discomfort of living with this chronic illness.

What is lichen planus, and how can it affect the mouth? 

Despite its name, suffering from lichen planus does not mean that you're going mouldy. Instead the name comes from the lesions that develop on the skin of some suffers, which can resemble the lichen and moss which grows on walls. However, lichen planus does not devote its attentions wholly to the skin, and some people who suffer from lichen planus can develop lesions on the mucosal linings of their mouths. This is referred to as oral lichen planus.

The causes of lichen planus are largely unknown, although it has been established that the disease is not contagious and cannot be passed from person to person through any form of contact. Instead, medical researchers believe that lichen planus is caused by an autoimmune reaction, during which the body's immune system becomes 'confused' and attacks its own tissues, causing the characteristic lesions. 

When lichen planus attacks the mouth and causes oral lichen planus, it can cause the following symptoms:

  • Oral lesions -- These may appear on the lips, mucous membranes (the lining of the mouth), gums and tongue, and can take a variety of forms. Some lesions present themselves as 'spider webs' of pale, raised tissue, while others manifest as tender patches of localised swelling or fluid-filled abscesses which can resemble more common bacterial oral infections.
  • Ulcers and sores -- These can resemble ordinary canker sores or more serious patches of damaged tissue, and can affect the gums and, by extension, the teeth.
  • Pain -- Most cases of oral lichen planus are painless when not provoked, although some patients report a burning, dry sensation that may be associated with the illness. However, lichen planus can also become painful when you are eating notably spicy or acidic foods, and can leave your oral tissues too tender to practise proper oral hygiene.

How can my dentist help treat oral lichen planus?

If you suspect that you are suffering from oral lichen planus you should book an appointment with your dentist as promptly as possible. Your dentist will inspect your mouth and the lesions that have formed, and determine whether or not oral lichen planus is causing the illness. This is an important step, as oral lichen planus can resemble other, more common oral illnesses such as thrush, which need to be discounted before treatments can begin.

Oral lichen planus can be a painful, uncomfortable and unsightly illness, but in most cases it is fundamentally harmless and causes no significant permanent effects. However, in some rare cases the damage caused by oral lichen planus can lead to the formation of cancerous growths. Your dentist, therefore, will also check for early signs of malignant growth.

As for treating the illness itself, dentists can offer a number of palliative treatments designed to minimise discomfort and the impact oral lichen planus has on your quality of life:

  • Pain relief -- If the damage caused by oral lichen planus is causing you pain, your dentist may offer you painkilling medication to counteract it. These are normally applied as topical gels directly to the damaged mucosal tissues, although in severe cases of pain you may be offered oral painkillers for stronger relief.
  • Corticosteroids -- Corticosteroids help to reduce pain and speed healing, and like conventional painkillers they are usually applied in topical gel form. Oral corticosteroids are also available for severe cases of damage and pain, but these are generally reserved for the most severe cases due to the unpleasant side effects associated with long-term corticosteroid use
  • Tooth shaping -- The damage caused by oral lichen planus causes the mucosal tissues to heal more slowly, and scratches and scrapes can easily develop into lesions or ulcers. As such, your dentist may offer to reshape any protruding or misshapen teeth you may have that can irritate and damage the mucosal linings. If you have dentures, your dentist will check for areas of irritation they may be causing, and may sent your dentures to a dental technician's lab to be reshaped.
  • Immunosuppressants -- In particularly severe cases of oral lichen planus, you may also be prescribed immunosuppressants, which reduce the damage caused by your body's errant immune system.