Living with oral lichen planus raises many questions. Here are comprehensive answers to the questions most commonly asked by patients and their families.
General Questions
Is oral lichen planus contagious?
No, absolutely not. Oral lichen planus is not contagious in any way. You cannot:
- Catch it from someone else
- Pass it to others through kissing or sharing utensils
- Spread it through saliva
- Transmit it through any form of contact
OLP is an immune-mediated condition, not an infection. It’s safe to share food, drinks, and have close contact with others.
Will my oral lichen planus ever go away completely?
Unlikely, but it may significantly improve or go into remission.
OLP is typically a chronic, long-lasting condition. However:
- Some people experience long periods with minimal or no symptoms
- Reticular OLP may remain stable and asymptomatic for years
- Symptoms often wax and wane
- Treatment can effectively control symptoms
- Spontaneous remission is possible but uncommon (about 5% of cases)
- Quality of life can be excellent with proper management
Can oral lichen planus turn into cancer?
There is a small increased risk, which is why monitoring is important.
Key facts:
- Approximately 0.5-2% of OLP cases may develop cancer
- This means 98-99.5% never develop cancer
- Risk is higher with erosive OLP than reticular OLP
- Regular monitoring allows early detection
- Eliminating risk factors (tobacco, alcohol) helps
- Most changes are NOT cancer
- Early detection significantly improves outcomes
Regular check-ups every 3-6 months are your best protection.
Is there a cure for oral lichen planus?
No, there is currently no cure, but effective treatments manage symptoms.
While we can’t cure OLP, we can:
- Control symptoms effectively
- Reduce inflammation
- Heal erosions and ulcers
- Prevent complications
- Maintain quality of life
- Minimize flare-ups
Why did I get oral lichen planus?
The exact cause isn’t fully understood, but it likely involves multiple factors.
Potential contributors include:
- Genetic predisposition
- Immune system dysfunction
- Environmental triggers
- Viral infections (especially hepatitis C)
- Medications
- Stress (may trigger, not cause)
- Contact allergies to dental materials
Important: It’s not your fault. You didn’t do anything wrong to cause this condition.
Diagnosis and Testing
How is oral lichen planus diagnosed?
Through a combination of clinical examination and biopsy.
The process typically includes:
- Visual examination – characteristic appearance of lesions
- Biopsy – small tissue sample examined under microscope
- Blood tests – to check for related conditions like hepatitis C
- Patch testing – if allergy to dental materials suspected
Should I be tested for hepatitis C?
Yes, screening for hepatitis C is generally recommended for all OLP patients.
Reasons:
- 15-30% of OLP patients have hepatitis C (varies by region)
- Treating hepatitis C may improve OLP
- Early detection important for liver health
- Simple blood test
- Important for overall health management
Treatment Questions
What’s the best treatment for oral lichen planus?
It depends on your specific type and severity of OLP.
For reticular OLP with no symptoms:
- Often no treatment needed
- Regular monitoring only
For erosive or symptomatic OLP:
- Topical corticosteroids (first-line treatment)
- Calcineurin inhibitors (alternative)
- Systemic medications for severe cases
- Pain management as needed
How long does treatment take to work?
Most people see some improvement within 2-4 weeks, with significant response by 6-8 weeks.
Timeline:
- Initial response: 2-4 weeks
- Significant improvement: 4-8 weeks
- Maximum benefit: 2-3 months
- Maintenance may be ongoing
Will I need to take medication forever?
Many people require long-term maintenance therapy, but not always at the same intensity.
Possible scenarios:
- Some need continuous low-dose maintenance
- Others use medication only during flare-ups
- A few achieve good control and stop treatment (with monitoring)
- Most fall somewhere in between
Daily Life Questions
What can I eat with oral lichen planus?
It varies by individual, but general guidelines help.
Usually well-tolerated:
- Soft, mild foods
- Cool or room temperature items
- Proteins like eggs, fish, tender meat
- Soft fruits (bananas, melons)
- Cooked vegetables
- Pasta, rice, mashed potatoes
- Smoothies and yogurt
Often problematic:
- Spicy foods
- Acidic foods (citrus, tomatoes)
- Very hot foods/drinks
- Crunchy or rough textures
- Salty foods
- Alcohol
Can I drink alcohol?
Best to limit or avoid alcohol, especially during flare-ups.
Reasons:
- Irritates oral tissues
- Can trigger symptoms
- Drying effect
- May interact with medications
- Increases cancer risk (combined with OLP)
Should I change my toothpaste?
Yes, switching to a gentler toothpaste often helps.
Avoid:
- Sodium lauryl sulfate (SLS)
- Whitening formulas
- Tartar control types
- Strong flavors
Choose:
- SLS-free options
- Sensitive teeth formulas
- Mild or no flavor
- Low abrasion
Brands that work well: Sensodyne, Biotene, Tom’s of Maine (SLS-free varieties)
Does stress make oral lichen planus worse?
Yes, stress is a common trigger for flare-ups.
Many people notice:
- Symptoms worsen during stressful periods
- Flare-ups following major life events
- Improvement when stress reduces
However, stress doesn’t cause OLP – the biological condition exists independently. Stress management can help reduce flare-ups.
Work and Social Life
Should I tell people about my oral lichen planus?
That’s entirely your personal choice.
You might want to tell:
- Close family and friends for support
- Employer if it affects work (for accommodations)
- Healthcare providers (always)
You’re not obligated to share with:
- Casual acquaintances
- Coworkers (unless it affects your work)
- Anyone you’re not comfortable telling
Can I kiss my partner?
Yes! OLP is not contagious.
You can:
- Kiss freely
- Share food and drinks
- Have normal intimate relationships
- Not worry about transmission
During painful flare-ups, you might find kissing uncomfortable personally, but this is about your comfort, not safety.
Special Populations
Can children get oral lichen planus?
Yes, but it’s rare in children.
- OLP is primarily an adult condition
- Can occur in children and adolescents
- May have better prognosis in young people
- Treatment similar but dosing adjusted
- Regular monitoring especially important
I’m pregnant – is my oral lichen planus dangerous for my baby?
No, OLP itself doesn’t affect pregnancy or the baby.
However:
- Some OLP medications aren’t safe during pregnancy
- Inform your OLP doctor and obstetrician
- Treatment plan may need adjustment
- Hormonal changes may affect symptoms
- Extra monitoring may be recommended
- Most women do fine with modified treatment
Long-term Outlook
What’s my long-term prognosis?
Most people with OLP live normal, healthy lives with proper management.
Expected course:
- Chronic condition (long-lasting)
- Symptoms typically manageable
- May have periods of remission and flare-ups
- Regular monitoring important
- Quality of life can be excellent
- Small cancer risk requires vigilance
- Many people adapt well and rarely think about it
Are new treatments being developed?
Yes, research into OLP continues, with new treatments being investigated.
Current research areas:
- Biologic therapies (targeting specific immune pathways)
- Novel topical treatments
- Laser and light therapies
- Better understanding of causes
- Genetic factors
- Microbiome connections
The Bottom Line
Living with oral lichen planus raises many questions, and it’s normal to feel overwhelmed initially. Remember that OLP is manageable, you’re not alone, and your healthcare team is there to support you. Don’t hesitate to ask questions – there are no “silly” questions when it comes to your health.
These answers provide general information about oral lichen planus. Your individual situation may differ, and you should always consult with your healthcare providers for personalized advice and treatment recommendations.
Oral LP 
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