Hi, I’m dr. Joe Nemeth I’m a periodontist
in Southfield Michigan and today I want to talk about a interesting subject
something called lichen planus or oral lichen planus. Lichen planus is basically
an autoimmune disease we don’t really know what causes it and there isn’t
really a predictable cure for it although there are treatments for it. If you have a
burning mouth and it’s quite uncomfortable and you don’t know why and
your dentist can’t figure out why it’s very possible that you do have lichen
planus. In order to confirm that typically we take a small sliver of
tissue and send it in for examination that’s called a biopsy and the biopsy
can give us a very definitive diagnosis of lichen planus and there are a number
of approaches to treating it not curing it but controlling it at least making it
more comfortable for you. Lichen planus can affect other parts of the body too
but we’re going to talk mainly about oral lichen planus. You know it’s
interesting I’ve been having a lot of patients lately who have Lichen Planus
they don’t know that they have it but they come in and their mouth is like
just burning or sore and they can’t figure out what it is and upon close
examination we can see little white patches in their mouth or little white
spots or sometimes we can see a lace-like pattern on the inside of the
cheek and these are the typical signs of lichen planus.
Now lichen planus can become much more severe it’s then called erosive lichen
planus and actually when it becomes erosive lichen planus there is a
slight but increased likelihood that it could evolve into oral cancer anywhere
from one to five percent of erosive lichen planus may become oral cancer and
so if one is diagnosed with lichen planus particularly the erosive or the
more severe kind of lichen planus one should get monitored periodically. First
of all if it’s not too painful or bothering you too much if it just feels
a bit rough there’s nothing necessary you don’t need
to do anything but if it’s starting to get uncomfortable the first line of
treatment is topical chordal of steroids put on the gum tissue to reduce the
inflammation and the discomfort. Sometimes if it’s more advanced than that or it’s
not responding oral corticosteroids and pill form may be taken. We’re also now
using a laser in some cases so there are a number of other treatments that are
being developed that can help improve the prognosis of lichen planus and make
it more comfortable. Now one other thing that I’ve noticed because I’ve been
seeing a lot of these cases and I don’t know if it’s coincidence or not but my
own feeling is environmental exposure can be a contributing factor to these
cases of lichen planus most of these patients many of them have
been exposed to strong fumes chemical fumes paint fumes sometimes pesticides.
In fact I just had a patient just a half-hour ago who was testing air bags
and was exposed to strong vapors from the air bags and he absolutely had like
in planets. So, I think there’s a lot of environmental factors people who have
asthma who’ve been using inhalers for a long period of time I’ve seen a number
of these people who are developing a burning mouth and lichen planus
but it may not show up for years maybe not 10 15 20 even 30 years later until
it manifests itself in the form of burning mouths and lichen planus. So here
are a couple of examples of patients with lichen planus and if you look you
can see a white patch here a white patch here kind of white patches here and this
tissue is red it’s sore it’s very uncomfortable and so something needs to
be done to help this patient reduce the discomfort and the pain associated with
that now this is a much more severe case of lichen planus
typical lace-like pattern very very obvious typically it’s not usually as
obvious as this and this will come and it’ll get better and get worse we have
periods of remission and exacerbation this actually was more uncomfortable
than that was and this is burning it’s very uncomfortable it’s red and we do what
we can to palliate this or reduce the
discomfort that the patient is having. I mentioned I saw a case just about a half
an hour ago a patient just left actually and this is that case the patient was
having chronic discomfort in the lower right side didn’t know why, couldn’t
figure it out this is a much milder case of lichen planus than the other two that
we showed you but still significant enough to make him uncomfortable and
let’s look closely. You can see white patch along here white patch along here
all along here and it’s actually just starting in the cheek but you can barely
see that that’s very very very faint so we’re going to do something we’ll probably
take a biopsy that is a sliver of tissue just to confirm the fact that it is Lichen Planus but there’s no doubt about it in my mind but not all lichen planus
cases are as obvious as the first who we showed you. So if you’re having symptoms
of a dry rough burning uncomfortable mouth get it checked out go to your
dentist go to a periodontist see what’s going on. Remember keep your mouth
healthy if you have a healthier mouth you’re definitely going to have a
healthier body have a great day! Restore your smile and your health with
the help of dr. Nemeth and his associates visit www.DrNemeth.com to
schedule your appointment today.

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