Lichen Planus – Burning Mouth Symptoms | Causes | Treatment

Lichen Planus – Burning Mouth Symptoms | Causes | Treatment

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 to
schedule your appointment today.

Author: Kevin Mason

28 thoughts on “Lichen Planus – Burning Mouth Symptoms | Causes | Treatment

  1. I know a few people with auto immune disorders. I'll be sure to relay this video to each of them. Though a few of the people I know have resolved a plethora of issues related to their health by eating much healthier. Thank you for taking the time to make these videos!

  2. An extremely informative and professional presentation. Thank you. I have had OLP for about 3 months now. I am awaiting the results of a biopsy but the Specialist said there was no doubt about the diagnosis. For me, the very worst aspect is that I have been unable to eat solid food for several weeks. Too painful. I have surfed the web to try to find an on-line support forum but, so far, the only two I came across are not very recent and almost inactive. It would be a great help if professionals gave not just advice but the contact details for on-line support. I find not being able to eat so distressing at times (I have not eaten out or gone to friends since it started) and would love to learn how others in my situation are coping.

  3. Good evening, Dr. Nemeth, I hope you had a good weekend too. Thank you for asking me. The problem seems to be worsening. The insides of my cheeks and gums are more swollen and sore now. I have to blow my cheeks out like puffer fish before I close my mouth or I catch and cut them when I close my mouth! My cheerful disposition is being tested to the limit :)) Spent yesterday with pieces of greasproof paper inside my cheeks to relieve the sores being rubbed by my teeth and tongue. It does give some relief. Trouble is, it goes soggy after a bit. Researched mouthguards & safest material to use inside mouth. Appears to be silicone – or gold! Think my wife might notice if I start rifling her jewellry box, so will have to settle for buying a thin, soft sheet of silicone and cut it into shape to pop between cheeks & teeth. Hope you have a good week. Chris.

  4. Hello Dr. Nemeth, I have oral lichen planus but it is not too severe, can this become oral cancer in the future years if I continue to have lichen planus, is this curable?

  5. I have the white lessions on the inner cheeks but don't have the burning of the gums. In the past I was given fluconazole, Nystatin because it was thought to be oral candida with no results. The strange thing is that my PCP has not done a biopsy but I will now be have to be urgent about this.

  6. Hello dr Neemth, I live in Canada and I have oral lichen planus. I was wondering if you know any oral lichen planus drs so that I can see them. If you do please let me know if you can. Thank you

  7. Hey doc, do you think Lichen Planus is a body's response to a strain of HPV? There are no tests for males for HPV which can affect the mouth. Love to hear your thoughts thanks

  8. I would love to speak with you. I believe I have a very severe case of OLP. When I show other patients they are shocked nobody has seen anyone as bad as mine. I would love your help and advice. I live in CA and would travel for help or hope for a referral to someone who might help me.

  9. I do have lichen planus in mouth no other dentist can't figure out the situation it bleeds when I brush and for no reason its very sensitive I tried home remedies nothing works. My dentist keep saying its lupus but I do have lupus in most parts but it started out with Lichen planus. I had a rash first then it went through my whole body including my mouth. My moth burns when something is spicy I can't eaten and bleeds. I have to go back to my old dentist that yells a fuss at me because my gums bleed. I do have it on my check in the mouth on left side it does burn a lot when eating something spicy. I do live in Michigan to. My other doctor had prescribe me to a different Periodontal

  10. its the mercury in our mouths causing it!!!! we already have proof of mercury poisening…dr. Nemeth doesnt know this because he doesnt have the time to look at all the research going on…he is the last one to know

  11. I have burning tounge everyday tounge is a bit whiter fluffy than a normal tounge. My mouth does. Not seem to burn. I went to a dentist he filled down a broken tooth. He washed his hands on antibacterial soap he then stuck his thumb on my tounge to hold it down. I can not remember him wearing gloves. I was aware of the burning a few hours later and ever since. He denies not wearing gloves went I phoned him.

    Can a thumb on the tounge with a bit of soap gel cause the burning tounge syndrome or is it just a coincidence that I became aware of the burning tounge then.

  12. Hello! So I responded to a couple comments then realized I should just put my OLP coping mechanisms here. Covering doctor info, diet, and dental hygiene.

    I have the lichen planus that produces lesions on my hands, feet, wrists, and ankles in addition to oral symptoms. My primary care is actually my dermatologist, not my dentist, because of this. For those of you who seem to be struggling to find a knowledgeable dentist, I recommend calling a dermatologist's office and seeing if they can recommend a dentist that their lichen planus or lupus patients use. Some dermatologists may be willing to take you on as a patient even though you are only presenting the oral symptoms, but they will insist you have regular dental care because while they can treat the skin, only a dentist can determine if you have a decaying tooth harboring an infection or a bad/unfavorable reaction to dental work like implants or fillings. No offence to dentists, Dr. Nemeth, but you are the first one I encountered who seems to know much about OLP (including my own dentist).

    Diet: no external salt/broths, no spicy foods, no alcohol, no coffee, no acidic foods, no fried or abrasive foods. There is a reason why rubbing salt in a wound hurts. Salt is abrasive. When your body detects a cut, it has an immune response. Not only are you causing pain to an already sore mouth, you are also causing microabrasions that stimulate a malfunctioning immune system. Salt water rinses and broth will cause these as well, so avoid them. Do not add salt to your food (cooked in is okay, but not sprinkled on top of like french fries or pretzels). Here in the US, our butter has a very high salt content, so start buying the no salt or no salt added butter. Spicy foods cause general irritation as does all forms of alcohol. 😭 Coffee is acidic, but it gets its own listing because most people don't realize that. Acidic foods does exactly what regular acid does – just at a far, far less dangerous level. OLP weakens the skin, so putting acid on it is not a good idea. This is not only coffee, but citrus (citric acid), pineapple, tomatoes and tomato products, and the list goes on. Search for an acid reflux 'do not eat' list and you'll have a good starting point. We just have to avoid acid in the mouth instead of acid in the stomach. Now, for the real pain – fried and abrasive foods. Again, it if cuts, avoid it. Most fried food is hard and scratchy (though, as a resident of south U.S., you can bet I just remove the fried outside of my fried chicken and enjoy anyway lol). Cereals can also scratch (RIP my shredded wheat addiction), so unless you are willing to let it go 100% soggy, that's out. Chips – crisps in the UK – are included. Just run your finger along the item and it if feels like it can cut the soft skin in your mouth, better avoid it. I order french fries with no salt (ask if it can be put from the frier directly into the container/dish and, if not, you would like to order something else) and then remove all the sharp ends before eating. Fry eggs in olive oil instead of butter and take off any sharp edges that might have formed. Yes, this diet is boring, but my mouth feels 99% better for it. Oh, tomato sauce tip – put it in a pot and cook on simmer for 8 to 12 hours and most of the acid will cook out. A tiny bit of sugar about an hour before you take it off should neutralize any remaining acid. Also, milk is a good base (opposite of acid on the ph scale), so if you think you were exposed to acid, swish some in your mouth to stop any possible irritation. Pretty sure that's why you're supposed to drink milk instead of water if food is too spicy, but I can't say for sure.

    Dental hygiene: Mint, Spearmint, peppermint, and cinnamon flavored products will irritate OLP. Now, some claim SLS and fluoride are as well, some aren't bothered. Fluoride does irritate my OLP, so I avoid it after discussing this with my dentist. Always let your dentist know if you stop using fluoride products because it does play a role in preventing cavities. SLS is the stuff that makes toothpaste foamy. That's it. Lots of foam, lots of SLS. The only toothpaste I found that meets all the above mentioned requirements is Hello's fluoride free natural watermelon kid's toothpaste and I've found it in WalMart and the Dollar store, so it's readily available. If you can't find it, try baking soda. Most boxes have the instructions on how much water to add to make it into toothpaste, but I can't lie – it's kind of disgusting. There are a lot fluoride free kids mouthwash, so I don't feel the need to mention a specific brand.

    I hope what I've learned and tried since my diagnosis helps. Good luck to everyone who reads this and is suffering!

  13. Well I am terrified now. Woke up 3 days ago with what seemed like extreme dry mouth. It has steadily gotten worse and more sensitive. Thought i had strep, went to the doctor. She thinks its burning mouth syndrome. I had never heard of it. This video does not ease my mind

  14. Been to an oral pathologist. Had biopsies and results were lichenoid stomatitis. No exact result of lichen planus….have had burning pain, white patches under tongue, red painful gums for 10+ years… doctor says lichen planus, one says leukoplakia, pathologist says pre cancer plus an auto immune condition-no cure….am living with something that I don’t know what the heck it really is. Anyone else have similar situation?

  15. Hello first a great video👍💕💗 my father has lichen ruber planopilaris. Since it has only my father, no one from my family, I wanted to ask if I can do a genetic test in a dermatologist? Because I'm afraid that I'll have them later too

  16. I was diagnosed with LP 6yrs ago. My first patch formed from a cut.  I was shaving and I cut myself. A Thick patch of itchy bumpy skin formed over it. I thought it was infected or something. I kept going to the doctors nobody could tell me anything. After 3yrs it finally went away on its on. I was on a diet at the time so knowing what I know now I think that played a part in it healing. Then I cut myself again shaving 😒 on my ankle and it happened again. Once again no one could tell me why or what it was. Finally A dermatologist biopsy it and diagnosed me with LP. I've never had my Lp spread around my body or not stem from an injury or me cutting myself. All until about 2 years ago I started to get dark itchy patches on my back my arms and my chest. I was on a lot of medicine for some years pain meds tramadol and percocets etc.  Something made me feel like that played a part in what was going on with my skin. So I stopped taking all my pain medicine. I figured I rather have the pain in my knee an then to continue to suffer with the skin condition. Narcotics overtime breaks down your immune system to keep your body from healing itself or functioning properly. It can cause you not to ovulate anymore. And a whole bunch of issues over longterm use.   That the doctors don't tell you when they prescribed these narcotics. Anyways I threw out all my medication, and I try to eat more healthy. The discipline with the eating is not always great or perfect at least for me it's hard. Then a friend directed to a herbal man, she said he aslo helped her and most of her friends with OLP, HALITOSIS, VLP, LS,LP of different types and symptoms with herbal medication.. I must say that since I started taking the herbal, medication Within 21 days the LP cleared from my back arms, chest and the whole body.. Both in and out of my body. Reading through the post I haven't seen anyone say that their LP formed originally from them cutting their selves with shaving or an injury. If you are interested in getting intouch with the herbal man for medication as well email him here

     [email protected]  OR  [email protected]

    and get the herbal medication.

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