Understanding and Managing Lichen Planus

Lichen Planus is an autoimmune disorder wherein the body's immune system mistakenly attacks its own tissues. The precise cause remains unknown, though factors such as stress, genetic predisposition, and certain medications may play a roll in triggering the condition. While it can affect people of all ages, it is more commonly observed in middle-aged adults.

Oral Lichen Planus is a chronic inflammatory condition that affects the mucous membranes inside the mouth. It often presents as white, lacy patches or red, swollen tissue and can sometimes cause painful sores. There are two main types; recticular, which appears as white patches and usually no related symtoms, and erosive, which appears as red, swollen tissues or open sores and may cause a burning feeling or pain.

The condition occurs when the immune system attacks cells of the oral mucous membranes for reasons that aren't known. Regular checkups are important because Oral Lichen Planus, especially the erosive type, may raise the risk of getting mouth cancer in the affected areas.

The symptoms of Lichen Planus can vary depending on the area affected. In the oral cavity, it often leads to:

• White, lacy patches on the gums, tongue or inner cheeks
• Red, swollen tissues in the mouth
• Burning sensation or pain
• Sores or ulcers
• Difficulty eating or speaking

If your gums are affected, they could become tender, and tooth-brushing may be uncomfortable. Ulcers or erosions sometimes occur and these are especially painful. Some patients (about 15%) may also have lesions on the skin caused by Lichen Planus. Mild cases can  be symptom-free. Factors such as stress, gentic predisprosition, and certain medications may play a role in triggering the condition.

In most people, Oral Lichen Planus is not serious. However, an important, although uncommon, feature of Oral Lichen Planus is a tendency to cancerous change, with about a 1% risk over a period of 10 years. In other words, 1 in 100 people develop cancer in the mouth. Oral Lichen Planus is not an infection and is not contagious (cannot be passed from person to person).

Oral Lichenoid patches are not Oral Lichen Planus. They may occur in a few people. It can be very difficult to distinguish them. These can be caused by medications, e.g. some drugs prescribed for high blood pressure and diabetes, or dental materials (mercury, nickel, gold, resins, acrylates).

Maintaining good oral hygiene is crucial for those suffering from this conditions. Proper care can help alleviate symptoms and prevents complications such as secondary infections.

Treatment for Oral Lichen Planus focuses on healing and easing the pain or other symptoms

• Symptomatic treatment: Anaesthetic agents applied to the skin can provide short-term relief for very painful areas. Analgesic mouthwashes such as Benzydamine can help.
• Corticosteriods: Topical steriods can be applied to the affected area. These medicines can lower inflammation related to Oral Lichen Planus. They can be applied directly to the mucous membrane, via a mouthwash, spray or paste onto the effected area.
• Systematic Treatment: In severe cases systematic treatment may be required. Oral corticosteriod's can be prescribed may be used to improve severe symptoms and lessen pain.

If the gums are affected, it is important the teeth are kept as clean as possible by regular and effective tooth brushing. If not, a build-up of plaque can make your gum condition worse. Your dental professional will be able oral hygiene advice. 

Maintaining good oral hygiene is crucial for those suffering from Oral Lichen Planus. Proper care can help alleviate symtoms and prevent complications such as secondary infections. Some effective methods include using

• a soft-bristled toothbrush
• switching to non-foaming toothpaste
• opting for alcohol-free mouthwash
• making dietary adjustments
• having regular dental check-ups

Using a soft-bristled toothbrush can prevent additional irritation to the already sensitive oral tissues. Brush gently and thoroughly, twice a day, to remove plaque and food particles without causing harm. Using TePe Special Care brush is recommended for brushing after oral surgery and for patients with sore or very delicate oral tissue, very sensitive root surfaces, extremely dry mouth and after radiotherapy.

Regular toothbrushing often contains foaming agents like Sodium Lauryl Sulphate (SLS), which can exacerbate oral sores. Switching to a non-foaming toothpaste can reduce irritation and improve comfort. TePe Pure Toothpaste is a good option as an SLS free toothpaste with a mild peppermint and the unflavoured TePe Pure Toothpaste is a good option for those who are sensitive to mint