Oral Lichen Planus: Causes, Symptoms, and Treatment

Oral Lichen Planus

Do you have a white spot on your tongue?

If so, you may have oral lichen planus.

This condition is a relatively common autoimmune disorder that can affect the mouth and other parts of the body.

While there is no cure, there are treatments available to help manage symptoms.

Read on to learn more about oral lichen planus, including its causes, symptoms, and treatment options.

What is Oral lichen planus?

Oral lichen planus is a condition that causes white patches on the tongue and inside of the cheeks. 

Sometimes oral lichen planus can also affect areas outside of the mouth, such as the lips, gums, roof of the mouth, throat, and eyes.

In some cases, signs of oral lichen planus are so mild that they are barely noticeable, while other people experience more severe symptoms.

Oral lichen planus is sometimes confused with oral thrush, which is a yeast infection that appears as white spots on the inside of the cheeks and lips.

However, unlike oral thrush, oral lichen planus does not itch or hurt.

Oral lichen planus is a fairly common condition that largely affects adults.  

It occurs when the body’s immune system attacks healthy cells in the mouth, leading to inflammation and visible white patches.

While oral lichen planus can’t be cured, there are treatments available to help manage symptoms and prevent complications.

Symptoms of oral lichen planus

The most common symptom of oral lichen planus is the appearance of white patches on the tongue and inside of the mouth.  

In some cases, these patches can cause discomfort or pain.

Other symptoms that may be associated with oral lichen planus include:

  • Dry mouth (xerostomia)
  • Painful sores (aphthous ulcers)
  • Difficulty swallowing or chewing
  • Bleeding gums
  • Burning sensations in the mouth
  • Difficulty moving the tongue, which may cause speech problems

Types of oral lichen planus

There are six types of oral lichen planus:

  • Reticular type
  • Erosive or ulcerative type
  • Atrophic (erythematous) type
  • Papular type
  • Bullous type
  • Plaque type

How common is oral lichen planus?

Oral lichen planus is a relatively common condition that particularly affects adults.

While the exact incidence of oral lichen planus is unknown, some studies have estimated that it affects between 0.1 percent and 5 percent of the population worldwide.

Oral lichen planus can appear at any age but usually starts after age 30.  

It’s more common in women than men, and Caucasians are more frequently affected than other racial groups.

Oral lichen planus is also associated with certain medical conditions, including

Causes of oral lichen planus

The exact cause of oral lichen planus is unknown, but it appears to be brought on by a malfunction in the immune system that causes it to attack healthy cells.

Hormonal changes and certain medications may also contribute to oral lichen planus.

In some cases, no cause can be found for the development of oral lichen planus.

How is oral lichen planus diagnosed?

Your doctor will usually be able to diagnose oral lichen planus by performing a physical examination. 

He or she may also ask you about your medical history and whether or not family members have a history of the condition.

You may be asked to provide a list of your current and past medications and supplements, as well as any procedures, surgeries, and dental work you’ve had in the past.

Your doctor will also want to know if there’s anyone else in your house who has similar symptoms or medical conditions.

In some cases, your doctor may also order one or more of the following tests to confirm a diagnosis of oral lichen planus: blood test for antinuclear antibodies biopsy of the mouth.

Treatment for oral lichen planus

Oral lichen planus is a chronic disease that can’t be cured, but there are treatments available to help manage symptoms and prevent complications.  

In some cases, treatment may involve medications or surgery.

The severity of the condition, as well as other health conditions you have, will determine what course of treatment your doctor recommends.

For mild cases of oral lichen planus, your doctor may recommend mouth care measures including:

  • Avoiding acidic foods and drinks, which can irritate the patches
  • Drinking plenty of water to keep the mouth moist
  • Avoiding toothpaste that contains Sodium Lauryl Sulfate (SLS)
  • Brushing teeth gently after meals or at least twice a day using fluoride toothpaste
  • Rinsing the mouth with salt water several times per day (you can mix ½ teaspoon of non-iodized table salt in 8 ounces of warm water)

For more advanced cases, your doctor may prescribe topical corticosteroids or immune suppressants to help control symptoms.  

In some cases, your doctor may prescribe antibiotics, anti-inflammatories, or antiviral agents.

Long-term treatment of oral lichen planus may involve the removal of affected tissue through surgical excision or laser techniques.

Treatment can also include plastic surgery procedures to ease discomfort and correct disfigurement.

What triggers Oral Lichen Planus?

In certain people, oral lichen planus may be triggered by:

  • Infection with certain bacteria, viruses, or yeast
  • Injury to the mouth from a dental procedure or orthodontics
  • Certain types of medications, including some that are taken orally, injected into the veins (IV) or applied to the skin

In some cases, stress may play a role in oral lichen planus.

Is Oral Lichen Planus serious?

Oral lichen planus is not a dangerous condition.

However, it can cause discomfort and limit your ability to eat certain foods.

What should I eat if I have Oral Lichen Planus?

Certain foods can aggravate oral lichen planus, so it’s a good idea to avoid acidic fruits and juices, such as oranges and grapefruit.

You should also avoid spicy food, hot liquids, and alcohol.

Although there’s no scientific evidence to support this claim, some people believe that drinking a glass of buttermilk daily may help alleviate symptoms.

Does Oral Lichen Planus come and go?

Oral lichen planus usually comes and goes in some patients.

In many cases, symptoms will disappear without treatment after several weeks or months.

Although there is no cure, most people can usually control the condition with proper treatment and avoiding alcohol and spicy foods.

The takeaway

Oral lichen planus is a chronic condition that causes patches of thin, white tissue to appear on the inside of the mouth.

It can cause discomfort and limit your ability to eat certain foods.

However, oral lichen planus is not dangerous, and most people can control the condition with proper treatment.

See a doctor if you have any symptoms of oral lichen planus, especially if they don’t go away or come and go.

Treatment for oral lichen planus will depend on the severity of your condition.