17875 Oral Lichen Planus

Overview

Oral lichen planus is a long-lasting condition that causes swelling, redness, white lacy patches, and sometimes painful sores inside the mouth. It is not an infection, and you cannot pass it to others.

It is fairly common, affecting about 1–2% of adults.

It most often affects middle-aged adults, especially women over 40, but it can occur at any age.

Symptoms

Common symptoms

• White, lacy patches on the inside of the cheeks, gums, or tongue
• Red, swollen areas or open sores
• A burning or stinging feeling, especially when eating hot or spicy foods
• Sensitivity to acidic foods like tomatoes or oranges
• Mild discomfort that may come and go
• Occasional bleeding from the affected area

Symptoms in children

• Oral lichen planus is rare in children, but it can happen.
• Children may have similar white patches or sores, but they may be less lacy in appearance.
• A child may be reluctant to eat or complain of mouth pain.

Symptoms in older adults

• Symptoms can last longer and heal more slowly.
• The condition may be mistaken for other mouth problems common in older age, such as denture-related sore spots.
• Older adults may need to coordinate care with both a doctor and a dentist.

Causes

Main causes

• The exact cause is not known, but it is thought to be an autoimmune reaction — the body's immune system mistakenly attacks the cells in the lining of the mouth.
• It is not caused by stress, but stress can make symptoms worse.
• It is not caused by a germ, so it cannot spread from person to person.

Risk factors

• Hepatitis C infection
• Certain medications, such as some medicines for high blood pressure or arthritis
• Dental fillings that contain metals, in a small number of people
• Stress or anxiety
• Other autoimmune conditions, such as thyroid disease
• Hormonal changes

When to see a doctor

See a doctor urgently if:

• If you have severe pain and cannot eat or drink
• If a sore in your mouth does not heal after two weeks
• If you notice a new lump, a growing sore, or a change in the look or feel of a patch

Book a routine appointment if:

• If you notice white patches, red areas, or sores that last for more than two weeks, have them checked by a dentist or doctor.
• If you have a history of oral lichen planus, keep up with regular follow-up visits.

Diagnosis

A doctor or dentist will look at your mouth and ask about your symptoms, your health history, and any medicines you take. They may refer you to a specialist, such as a dermatologist or an oral medicine specialist, for a closer look.

Tests that may be done

• A biopsy — a tiny sample of tissue from the affected area is taken and examined under a microscope.
• Blood tests to check for other conditions, such as hepatitis C or autoimmune diseases.
• Allergy testing in some cases, to see if a dental filling or food is a trigger.

What to expect at your appointment

A biopsy is usually done with a numbing medicine, so you should not feel pain. The sample is sent to a lab, and results may take a week or two. Your doctor will explain the results and discuss next steps with you.

Treatment

Treatment is not always needed if symptoms are mild. The main goal is to relieve pain, reduce swelling, and keep your mouth comfortable. There is no cure, but most people can manage their symptoms well.

Self-care at home

• Avoid spicy, salty, acidic, or crunchy foods that can irritate your mouth.
• Use a soft toothbrush and gentle toothpaste.
• Quit smoking and limit alcohol, as these can trigger flare-ups.
• Try stress-relief techniques, like breathing exercises or meditation.
• Rinse your mouth gently with plain water after meals.
• Keep a diary of what triggers your symptoms, and avoid those triggers.

Medical treatments

Your doctor may prescribe a mouthwash, gel, ointment, or spray that contains a steroid to reduce inflammation. These are used for a limited time, as directed by your doctor. In more severe cases, other medicines that help the immune system may be suggested, or you might be referred to a specialist. Always ask your doctor about the best option for you, and never share prescription medicines with others.

When is surgery considered?

Surgery is rarely used to treat oral lichen planus. In uncommon situations, if a sore does not heal and causes concern, a biopsy might be done to rule out other problems, but surgery is not a first-line treatment.

Living with this condition

Keep a soft, bland diet when symptoms flare up. Choose foods like lukewarm soups, porridge, bananas, and cooked vegetables. Stay consistent with gentle mouth care and see your dentist for regular cleanings and check-ups.

Lifestyle tips

• Quit smoking or using tobacco products.
• Reduce stress through yoga, tai chi, or meditation.
• Avoid alcohol and alcohol-based mouthwashes.
• Drink plenty of water to keep your mouth moist.
• Get regular sleep to help your immune system stay balanced.

Diet and exercise

Eat a balanced diet with plenty of fruits and vegetables. During a flare-up, you may need to stick to softer, plain foods. Gentle exercise, like walking or swimming, can help lower stress, which may reduce flare-ups.

Mental health and emotional wellbeing

Living with a chronic mouth condition can be stressful and may affect your confidence or mood. It is normal to feel frustrated, scared, or self-conscious at times. Talking to a counselor or joining a support group can help you cope.

Prevention

There is no known way to prevent oral lichen planus, because it is thought to be an autoimmune condition. However, you may be able to reduce flare-ups by avoiding known triggers, such as certain foods, alcohol, tobacco, and unmanaged stress.

Screening programmes

Regular mouth checks with your dentist or doctor are important, especially if you have oral lichen planus. Even if you have no symptoms, a professional can spot any changes early. Ask how often you should be screened.

Complications

If left untreated

• Symptoms may cause persistent pain and make eating or drinking uncomfortable.
• Open sores or ulcers can develop and may bleed.
• In a small number of people, oral lichen planus may increase the risk of mouth cancer, so follow-up is essential.

Long-term outlook

Most people with oral lichen planus have times when symptoms are mild or absent. With simple self-care and medical help when needed, you can keep the condition under control. Because there is a link to mouth cancer in a few cases, staying in regular contact with your doctor and dentist gives you the best chance of catching any problems early.

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