Oral lichen planus


Oral lichen planus

Description, Causes and Risk Factors:

Abbreviation: OLP.

OLP is a chronic inflammatory, non-infectious disease that causes lesions on the buccal mucosa, tongue, and/or gums. It affects approximately 1-2% of the general adult population. Although OLP predominantly occurs in adults older than 40 years, younger adults and children can also be affected, where as lichen planus may affect either skin or genitals; or in any combination of two or more.

Despite a great deal of research, the cause of mouth OLP remains a mystery. Current thinking suggests that stress or tissue injury may cause the eruption. Some researchers think certain foods like citrus fruits, tomatoes, and some nuts may complicate the problem. A minor injury, such as biting the inside of your mouth may also trigger OLP.

Some cases of complex OLP are caused by an underlying health condition, such as an impaired immune system; nutritional problems, such as vitamin B12, zinc, folic acid, or iron deficiency; and gastrointestinal tract disease, such as Celiac disease and Crohn's disease.

Some women may develop OLP as a part of the pre-menstrual syndrome. Stress appears to be a major player. Stress is also a major trigger factor. Genetic factor is usually found in the back ground. OLP is considered pre-cancerous. However, it is not so common for OLP to turn cancerous.

Factors that may act as triggers of oral lichen planus:

• Hepatitis C infection and other types of liver disease.

• Hepatitis B vaccine.

• Certain types of flu vaccines.

• Allergy-causing agents (allergens), such as foods, dental materials or other substances.

• Nonsteroidal anti-inflammatory drugs.

• Certain medications for heart disease, high blood pressure, or arthritis.

Factors that may complicate the condition or worsen symptoms include:

• Alcohol.

• Tobacco products.

• Rough dental work.

• Poorly fitting dentures.

• Poor oral habits, such as biting the lip or cheeks.

• Buildup of dental plaque or tartar.

• Stress.

Symptoms:

The primary signs and symptoms of OLP are the lesions affecting the mucous membranes of the mouth.

Appearance:

• The lesions may appear as white, raised patches of tissues.

• Red, swollen, tender patches of tissues.

• Open sores.

These lesions may appear on the following sites:

• Gums.

• Tongue.

• Inner tissues of the lips.

• Throat.

• Esophagus.

The lesions of OLP are usually bilateral. OLP lesions may be associated with patchy brown melanin (pigment) deposits in the oral mucosa.

Diagnosis:

The physical examination is usually the most useful and revealing part of the OLP diagnosis. The physician will look for small red ulcers covered in a gray-yellow coating, possibly encircled in a halo of white or red. The physician also identify where in the mouth the lesions occur. There are several visual cues that can help make the physician make the diagnosis.

There is no specific blood test for a OLP, but the physician will likely take some blood tests to rule out other causes of mouth sores. These tests usually include a complete blood count (measures the number of WBC (white blood cells), RBC (red blood cells), and platelets in the blood and a hemoglobin test. Abnormalities in these blood tests may lead to further diagnostic tests. Serum antiendomysial antibody, antigliadin antibody and transglutaminase assay may be performed if celiac disease is suspected. Often the blood levels of several key vitamins are measured including Vitamin B12, folate (folic acid), and iron. While a vitamin deficiency does not necessary confirm a OLP diagnosis, it can be highly suggestive.

A biopsy and examination under microscope is usually needed when the ulcers are very severe.

Treatment:

There is no known cure for either simple or complex OLP. But the following remedies provide relief:

• Soothe the sores. Apply boroglycerine using cotton buds. It will provide good relief. You may also use ghee or butter oil.

• Use ice. Ice will soothe the sores.

• Use special lozenges. Your dentist or physician may recommend hydrocortisone lozenges to speed up the healing process.

• For a severe attack, your doctor may also recommend a prescription mouthwash, a corticosteroid salve or an anaesthetic solution.

• Mouth rinses. Add half-a-teaspoon of table salt to a cup of lukewarm water and rinse your mouth. Repeat every few hours. This may sting a bit. Bland mouth rinses also help to keep the ulcers clean.

• Take vitamin pills. Use a multivitamin pill, one a day, to tide over the sores. The basis being vitamins could nullify the ill-effects of stress.

• Avoid abrasive, acidic or spicy foods.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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