If you suffer from lesions in your mouth that make eating painful, your primary care doctor may refer you to an ear, nose, and throat doctor. Oral lichen planus, an autoimmune disease, may be found. If so, here's what you can expect during diagnosis and treatment:
How is it diagnosed?
Your ear, nose, and throat doctor can tell a lot by just looking at the lesions in your mouth. Oral lichen planus is characterized by a white lacy appearance on the inside of your cheeks and sometimes on your tongue. You may have also white or red patches or ulcers. Your doctor may also examine cells under a microscope to further confirm the diagnosis.
What should you expect after diagnosis?
Depending on the severity of your condition and any risk factors or suspected triggers, your doctor may perform a biopsy on one of the lesions. He or she may also use a swab to collect cells from your mouth. They'll be examined under a microscope to help determine if you may have a viral or bacterial infection. If an allergy is a suspected trigger, you may also be referred to an allergist for additional testing.
Lichen planus may also increase your risk of developing oral cancer. Your doctor may recommend that you receive oral cancer screenings regularly, especially if you're a smoker or use oral tobacco or have done so in the past. It's also important to stop using these products if you still do so.
In addition, you'll need to keep your mouth as clean as possible and visit your dentist at least twice a year. It's important to avoid letting tartar or plaque build up. Brush at least twice a day, but be careful not to brush too vigorously. Avoid mouthwashes that have alcohol in them, because they could further irritate your mouth. Your doctor may instead prescribe a special mouthwash as part of your treatment.
If spicy foods or acidic foods or drinks make your symptoms worse, eliminate them from your diet. Avoid foods like sharp chips or crusty bread that can further irritate your mouth. If your mouth is especially painful, try soft, bland foods. Also avoid alcohol and eat a healthy, balanced diet.
Some cases of lichen planus don't require any medication, but if your mouth is particularly painful, your ear, nose, and throat doctor may prescribe some of the following:
- Mouthwash to help numb your mouth temporarily
- Topical corticosteroids (a steroid that's often used as a spray or gel)
- Topical antimycotics (antifungal medication used if you also have an infection)
What's the long-term prognosis?
Most cases of oral lichen planus can't be cured, but you can control the symptoms. It often goes away spontaneously after a period of time, which unfortunately may be several years in some cases. However, if you and your doctor can pinpoint the cause of your lichen planus, such as reaction to a medication or an allergy, your chances of a speedier recovery are better.
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