What is Oral Lichen Planus?

What is Oral Lichen Planus?

what causes lichen planus
Oral Lichen Planus is a chronic autoimmune disorder that affects the mucous membranes in your mouth. It can cause a burning feeling, redness and swelling and you may have white patches in your mouth. If you have it, it doesn’t go away but you can control it.  


Lichen Planus is more common in women than men and usually occurs in people over the age of 40; however children and young adults can get it as well.  


While it’s not known exactly what causes oral Lichen Planus, doctors think it could be linked to your immune system. Usually your cells protect you by attacking viruses and bacteria, but with lichen planus those cells attack the oral mucous membranes causing lesions. These lesions may be lacy in appearance, white patches of tissue, red, swollen, tender areas of tissue or open sores. They can show up on the insides of your cheeks (most common), gums, tongue, and inner tissues of your lips or on your palate. It may run in your family, however, it is NOT contagious and can’t be passed from one person to another.  


Lichen Planus can start slowly or symptoms can come on all of the sudden. Symptoms include:
  1. Dryness in your mouth
  2. Burning sensation or pain
  3. Bleeding and irritation when you brush your teeth
  4. Metallic/burning taste
  5. Painful thick, white patches on your tongue, gums, cheeks, palate.
    1. They may include tiny dots or lines or a lacy pattern
  6. Discomfort when you talk, chew or swallow
  7. Redness and swelling of the gums
  8. There may be blistering or peeling
The sores can burn and be very painful and worsen when you eat or drink things that are salty, spicy, and acidic (like orange juice or tomatoes) or alcohol. Crispy foods (sharp edges) and caffeine can also be problematic. Medications may be factors as well, like painkillers, diabetes, and high blood pressure or malaria drugs. Dental fillings or a reaction to metal could cause a reaction or other problems in your mouth like a rough crown or tooth. An injury to your mouth or an infection may trigger lichen planus. Also, if you have a habit of biting your tongue or cheeks, this can contribute to it as well. Many people with Hepatitis C virus get lichen planus so that could be a possible link too.


If your symptoms are not severe and you feel only mild roughness in your mouth, you may not need any treatment at all. If you have sores or are in pain, your doctor may recommend a corticosteroid cream or in more severe cases, he/she may prescribe steroid pills. Severe oral lichen planus can increase your risk for:
  • Severe pain
  • Stress or anxiety
  • Oral cancer
  • Weight loss or a nutritional deficiency
  • Depression
  • Secondary oral yeast or fungal infections
  • Scarring from abrasive lesions


Be aware of what you eat and drink. Some foods and drinks, like those that are spicy or have citrus can make your symptoms worse. Also, too hot or too cold drinks cause discomfort.  
  • Stress can make symptoms worse.
  • Treat any issues that can trigger or worsen Lichen Planus
  • Don’t smoke
  • Environmental Exposure – avoid chemical vapors, paint fumes, pesticides, asthma inhalers
  • Drink alcohol only occasionally
  • Include lots of fruits and vegetables in your diet, though avoid those high in acid
  • Have your dentist replace any damaged fillings or polish sharp teeth
  • Check with your doctor to see if any of your medications could be causing it
  • Brush your teeth twice daily and floss once daily
    • Use a soft toothbrush and mild toothpaste
  • Be sure to see your dentist twice yearly for cleanings and check-ups
While a diagnosis of oral lichen planus can be frightening, keeping on top of symptoms is key to keeping it under control. See your doctor if you notice any changes in your mouth or any symptoms that signal something feels different. Be aware of what your mouth may be telling you. As I always say, healthy mouth, healthy body! We care about our patients and their overall health. If you have any questions or would like to schedule an appointment to see us, please call