Causes and risk factors
The exact cause is not known. It is an autoimmune disease in which CD 8 + T lymphocytes and cytokines TNF [tumour necrosis factor] attack the epithelial lining which causes cell death. Some predisposing factors include oral drugs like antibiotics, NSAIDs, anti hypertensive. It is called as ‘oral lichenoid drug reaction’. Other causative factors are allergens such as from toothpastes, mechanical injury during brushing, infection especially hepatitis C.
Clinical presentation
Oral lichen planus presents in three forms – reticular, erosive or atrophic, and plaque type. Reticular type consists of symmetrical lace like pattern. It affects tongue or gums. It may lead to ulcerations. Atrophic or erosive lichen planus cause erosions with white border. It can be a painful condition. It affects gums and lips. Plaques are white patches similar to oral keratosis. They are commonly seen in smokers.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Tissue biopsy is performed to rule out oral cancer. Routine blood tests are done.
Treatment
Treatment depends upon the underlying cause. The agent that is causing the disease should be avoided such as drugs or the toothpaste. Strict oral hygiene should be practised with regular dental checkups. Medical treatment consists of topical steroidal ointments, gels, retinoids or injectable steroids. Immunosuppressant drugs may be given in some cases. Doctor will advise to quit smoking, use of tobacco, and alcohol consumption. Limiting oral injuries, avoiding stressful events or situations will also help in managing the condition.
Other Modes of treatment
The other modes of treatment can also be effective in treating oral lichen planus.
Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating oral lichen planus.
