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Oral lichen planus (OLP) develops as a persistent inflammatory disease that affects the mucous membrane located within the mouth. The global population demonstrates a 1.27% to 2.0% prevalence rate for OLP, and this condition becomes more common among middle-aged adults. The disease occurs more often in women than in men because the female-to-male ratio is 3:2. Active disease management depends on the proper identification of underlying factors, symptom recognition, and treatment availability. Oral lichen planus is also a potentially cancerous oral disease. In this blog, we will discover more about this inflammatory disease, its various causes, symptoms, and available treatment options.
Synopsis
Causes of Oral Lichen Planus
Oral lichen planus (OLP) is a chronic inflammatory condition affecting the mucous membranes inside the mouth. Although any age group can develop this condition, the onset of oral lichen planus occurs most commonly during early middle age, between 30 and 60 years. The exact cause remains unclear, but several factors may contribute to its development. Below are the most well-known causes of oral lichen planus:
Immune System Dysregulation
OLP is considered a T-cell-mediated chronic inflammatory tissue reaction that results in a cytotoxic reaction against epithelial basal cells.
Genetic Predisposition
Genetic factors may influence immune function, increasing susceptibility to OLP. For example, a study in China found an association between a polymorphism in the TNF-alpha gene and a subset of patients' risk for oral LP.
Infections
Systemic infections, particularly with the Hepatitis C Virus (HCV), have been associated with an increased risk of developing OLP. The exact mechanism linking HCV to OLP is still under investigation.
Stress and Psychological Factors
Chronic stress, anxiety, and depression have been reported more commonly in individuals with OLP, suggesting that psychological factors may play a role in its onset or exacerbation.
Oral Lichen Planus: Symptoms to Watch For
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White, Lacy Patches (Wickham's Striae): These net-like white lines often appear on the inner cheeks and are typically painless.
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Red, Swollen Tissues: Inflamed areas may cause discomfort, especially when consuming spicy or acidic foods.
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Open Sores or Ulcers: Painful erosions can develop, leading to burning sensations and difficulty eating or swallowing.
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Desquamative Gingivitis involves peeling or shedding of the gum tissue, resulting in redness and sensitivity.
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Plaque-like Lesions: Thickened white patches resembling leukoplakia may form, particularly in tobacco users.
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Papular Lesions: Small, raised bumps can appear on the mucous membranes, often unnoticed due to the absence of pain.
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Bullous Formations: Rare fluid-filled blisters may develop, which can rupture and lead to painful ulcers.
If you experience these symptoms, consult an experienced oral medicine specialist in Bangalore for proper evaluation and management.
Diagnosis and Tests
Accurate diagnosis of oral lichen planus is essential for effective management. Several diagnostic methods are employed to confirm OLP.
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Patient History and Clinical Evaluation: A thorough patient history and clinical examination are vital for diagnosing lichen planus.
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Biopsy and Histopathological Examination: To confirm the diagnosis, a skin biopsy, typically an oral biopsy, is performed. Histopathological analysis reveals characteristic features such as parakeratosis, acanthosis, and saw-toothed rete pegs.
If you suspect OLP, consult our top Oral Medicine specialist in Bangalore for an appropriate diagnosis and treatment regimen.
Treatment Options for Oral Lichen Planus
Oral Lichen Planus (OLP) is a chronic inflammatory condition affecting the mouth's mucous membranes. While there's no definitive cure, various treatments aim to alleviate symptoms and improve quality of life. Below are standard treatment options:
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Topical Corticosteroids: First-line therapy involves applying corticosteroid creams or ointments directly to affected areas to reduce inflammation and discomfort.
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Systemic Corticosteroids: For severe or widespread OLP, oral corticosteroids may be prescribed to control inflammation.
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Immunomodulators: For severe cases and cases not responding to steroids, immunomodulating/immunotherapy is given.
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Oral Hygiene and Lifestyle Modifications: Maintaining good oral hygiene, avoiding tobacco and alcohol, and reducing stress can help manage OLP symptoms and prevent exacerbations.
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Periodic Follow-up: Regular follow-up appointments are important due to the potential risk of the condition developing into cancer. During these visits, the oral medicine specialist will carefully examine the affected area and monitor for any changes that may suggest progression towards malignancy.
Prevention and Self-Care
While there's no known cure, specific self-care measures can help manage symptoms and prevent flare-ups. Below are recommended practices:
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Maintain Good Oral Hygiene: Gently brush your teeth twice daily with a soft-bristled toothbrush and mild toothpaste. Floss daily to reduce plaque buildup and prevent infections.
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Avoid Irritants: Patients are advised to avoid spicy, salty, or acidic foods, as these may irritate the oral tissues. It is also recommended to limit the intake of caffeine and to refrain from consuming alcohol and using tobacco products, as these substances can worsen symptoms. Additionally, certain ingredients such as food colouring and cinnamon have been identified as potential triggers for oral lichen planus and should be avoided where possible
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Manage Stress: To reduce stress, use relaxation techniques like meditation, yoga, or deep-breathing exercises. Stress can trigger or worsen OLP symptoms.
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Regular Dental Check-ups: Schedule routine dental visits for professional cleanings and early detection of any changes in your oral health.
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Use Prescribed Medications: Apply topical corticosteroids or other medications as directed by your healthcare provider to control inflammation and alleviate discomfort.
Conclusion
Oral Lichen Planus (OLP) requires timely diagnosis, appropriate treatment, and consistent self-care to effectively manage symptoms. Regular dental check-ups are essential due to the condition’s potential for malignant transformation. In addition, managing stress and avoiding known irritants play a crucial role in preventing flare-ups. If you experience persistent oral discomfort, it is important to seek professional evaluation without delay. Early intervention can lead to better outcomes and significantly improve the quality of life for individuals living with OLP.
Visit our best dental hospital in Old Airport Road, Bangalore, for effective management of all oral conditions.
FAQ's
No, oral lichen planus is not contagious. It does not spread through saliva, sharing utensils, or close contact.
Yes, Oral Lichen Planus (OLP) is considered a potentially cancerous condition. However, the risk of malignant transformation is low, with studies estimating it at approximately 2.28%. Regular monitoring and early intervention are important, as they help reduce this risk and support better long-term outcomes.
Oral lichen planus can also affect the skin, scalp, nails, and genitals, though oral involvement is most.
Yes, studies suggest a link between OLP and autoimmune diseases, hepatitis C, and diabetes, but more research is needed to provide a conclusive statement on this matter.
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