The Management of Oral Lichen Planus

A Peer-Reviewed Publication Written by Kimberly M. Parsons, EdD, CDA, EFDA, RDH

Abstract

Oral lichen planus is an immune-mediated and chronic inflammatory condition that can cause erosion of the oral mucosa. The disease is described as reticular, erosive, atrophic, or bullous in nature, and it typically develops in women in their fifth and sixth decades. Reticular oral lichen planus, absent erythema, is asymptomatic and does not usually need intervention. However, as there is potential for conversion to carcinoma, reticular oral lichen planus associated with erythema or erosion needs treatment and periodic re-evaluation. The literature suggests that erosive and ulcerated oral lichen planus is best managed with topical corticosteroid preparations and, in refractory cases, systemic steroids. Several other immunosuppressive medications and non-medication based interventions are also available, but at greater cost and with greater potential for adverse reactions and side effects. This educational review article focuses on best practices in the management of oral lichen planus.

Educational Objectives

At the conclusion of this educational activity, participants will be able to:

1. Describe interventions used to manage oral lichen planus

2. Identify the appropriate medications to be prescribed for managing erosive and ulcerative oral lesions

3. Implement treatment strategies for managing oral ulcers associated with the disease

4. Identify interventions discussed in the literature that are supported by limited evidence

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