Oral LP

Oral lichen planus (OLP) is a chronic inflammatory condition that affects the mucous membranes inside your mouth. If you’ve been diagnosed with this condition or suspect you might have it, understanding what it is can help you manage it more effectively.

The Basics of Oral Lichen Planus

Oral lichen planus is an ongoing inflammatory disorder that occurs when your immune system mistakenly attacks the cells of your oral mucous membranes. The exact reason why this happens remains unknown to medical researchers, but it’s important to know that this condition is not contagious—you cannot pass it to others through contact.

The name itself gives us clues about the condition. “Oral” refers to the mouth, while “lichen planus” describes the characteristic appearance of the lesions, which can sometimes resemble the lichen that grows on trees and rocks.

How Common Is It?

Oral lichen planus affects approximately 1-2% of the general population. It can occur at any age, but it’s most commonly diagnosed in middle-aged adults, particularly women. The condition affects women about twice as often as men, typically appearing between the ages of 30 and 60.

The Two Main Types

Understanding the type of oral lichen planus you have is crucial for treatment planning:

Reticular Oral Lichen Planus

This is the most common form of OLP. It appears as white, lacy, web-like patches inside the mouth, most often on the inner cheeks. These patches are called Wickham’s striae. Reticular OLP usually causes no discomfort and may not require active treatment beyond monitoring.

Erosive Oral Lichen Planus

This more severe form appears as red, inflamed areas or painful open sores in the mouth. Erosive OLP can cause significant discomfort, including burning sensations, pain while eating or drinking, and sensitivity to certain foods. This type requires closer medical supervision because it carries a slightly increased risk of developing into oral cancer.

Where Does It Appear?

Oral lichen planus most commonly affects:

• Inner cheeks (buccal mucosa) – the most frequent location
• Tongue – sides and top surface
• Gums (gingiva) – can cause desquamative gingivitis
• Inner lips
• Palate (roof of the mouth)
• Floor of the mouth

Some people develop lesions in just one area, while others may have multiple affected sites throughout their mouth.

Is It Related to Skin Lichen Planus?

Yes, oral lichen planus is related to lichen planus of the skin, but they don’t always occur together. About 50% of people with oral lichen planus also develop skin lesions, which appear as purple, itchy, flat-topped bumps. However, many people have oral involvement without any skin symptoms.

The Chronic Nature of OLP

One of the most important things to understand about oral lichen planus is that it’s a chronic condition. This means:

• It’s long-lasting and typically doesn’t go away completely
• Symptoms may come and go, with periods of flare-ups and remission
• While there’s no cure, symptoms can be effectively managed
• Regular monitoring by healthcare professionals is important
• The condition can last for years or even decades

What Oral Lichen Planus Is NOT

It’s helpful to clarify some common misconceptions:

• Not contagious – You cannot spread it to others
• Not an infection – It’s not caused by bacteria, viruses, or fungi
• Not cancer – While erosive OLP requires monitoring, the condition itself is not cancerous
• Not caused by poor oral hygiene – Though good oral care is important for management

The Immune System Connection

Oral lichen planus is considered an autoimmune condition, meaning your immune system is involved in creating the problem. In OLP, T-cells (a type of white blood cell) accumulate in the oral tissues and trigger inflammation. This immune response damages the basal cells of the oral mucous membrane, leading to the characteristic lesions.

Researchers are still working to understand why this immune response occurs. Potential triggers and contributing factors may include:

• Genetic predisposition
• Viral infections (particularly hepatitis C)
• Certain medications
• Allergic reactions to dental materials
• Stress and anxiety
• Other autoimmune conditions

Living with Oral Lichen Planus

While the diagnosis of a chronic condition can feel overwhelming, many people with oral lichen planus live normal, healthy lives with proper management. The key is working closely with healthcare providers to:

• Monitor the condition regularly
• Manage symptoms effectively
• Identify and avoid triggers
• Maintain excellent oral hygiene
• Watch for any changes that might require treatment adjustments

Looking Ahead

Understanding that oral lichen planus is a chronic inflammatory condition—not an infection, not contagious, and not your fault—is the first step toward effective management. In subsequent articles, we’ll explore how to recognize the symptoms, what treatments are available, which healthcare providers to see, and practical tips for living well with this condition.

Remember, while OLP is chronic, it’s manageable. With proper care and monitoring, most people with oral lichen planus can maintain good oral health and quality of life.

This article is for informational purposes only and is not a substitute for professional medical advice. If you suspect you have oral lichen planus, consult with a qualified healthcare provider for proper diagnosis and treatment.