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autoimmune condition

Soft Tissue Conditions: Before and After Treatment

A periodontist is mainly concerned with diagnosing and treating soft tissue problems. Some soft tissue conditions include Lichen Planus, Benign Mucous Membrane Pemphigoid, Geographic Tongue, Burning Mouth Syndrome, Aphthous Ulcers and Oral Mucositis from Chemotherapy.

Soft tissue disorders of the mouth are seen in patients of all ages, races and health statuses.

Oral Lichen Planus (or OLP) is a chronic inflammatory autoimmune disease which most commonly affects the skin and the mucous membrane lining or “skin” inside of the mouth, including cheeks and lips. OLP often looks like white lines crossing in a web-like patter on a red background, but can have a few different appearances, and some patients even develop a painful condition where ulcers are present (Ulcerative Lichen Planus).

OLP is caused by an inappropriate production of antibodies against a person’s own oral tissues. OLP affects 0.5-4% of the population globally, affecting women 2:1, often appearing in 50 and 60 year old post-menopausal women. It can affect quality of life, sleep, cause stress to those who have it, and usually persists for life. The lesions of Lichen Planus also have the potential to become malignant.

Oral Lichen Planus can be diagnosed in our practice with examination, and often requires a soft tissue biopsy. Other soft tissue conditions in the mouth can present with similar symptoms, so proper diagnosis is key, If confirmed to be Oral Lichen Planus, his patients are then treated accordingly, often with prescription gels or creams to be used in the mouth.

Pemphigoid is another soft tissue condition we see in our patients. Mucous membrane pemphigoid (MMP) is a rare chronic autoimmune disorders that can be characterized by blistering lesions that primarily affect the various mucous membranes of the body. The mucous membranes of the mouth and eyes are most often affected.

We often recommend specialty oral rinses, toothpaste and dietary changes to successfully treat soft tissue conditions.

If you’ve noticed sores or white ulcerations in your mouth, it’s possible you have a non-contagious disease known as Lichen Planus.  Many patients do not even realize they have it because it may cause no noticeable symptoms.  Many times, you may not even be aware you have the condition unless pointed out during a dental exam.  Although usually benign, it’s still a good idea to have it examined and monitored.  

The lesions of Lichen Planus are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be an autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, Lichen Planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.

Inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Sometimes it has ulcerations that come along with it.  Although there’s no known cure for Lichen Planus, it rarely causes serious problems.  It may even fade away on its own in time.  Chances are if you have a case of Lichen Planus it isn’t causing you any problems. If it does cause you discomfort, you can take steps to ease your symptoms.

If the lesions do become uncomfortable (painful, itchy or overly-sensitive), we recommend brushing with a soft toothbrush, flossing with soft woven floss (to avoid irritating or traumatizing the tissues).  Effective plaque control is important to keep the condition under control.  It may also be smart to avoid acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.

Perhaps the greatest concern with Lichen Planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.

 If you would like more information on Lichen Planus and similar oral conditions, please contact us or schedule an appointment for a consultation.

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