Lichen Planus Protocol

Follow Dry Mouth Guidelines.

  1. Drink 64-80 oz. of water per day. 
  2. Use a soft toothbrush and brush thoroughly to remove plaque.
  3. Avoid caffeinated beverages and acidic beverages.
  4. Salt water or baking soda rinses sometimes calm tissues. Rinse as needed.
  5. Avoid tobacco and alcohol.
  6. Avoid spicy acidic or salty foods.

Use SLS-free toothpaste such as Biotene, Pronamel, Orajel for dry mouth, Sensodyne, or Prevident. (Avoid mint flavors.)

Have regular oral exams and dental cleanings because there are some reports showing a risk of malignancy associated with lichen planus and early diagnosis is key.

Here are some recommendations that have been published in literature to reduce oral cancer risk:

  1. Do not smoke or dip tobacco.
  2. Avoid alcohol.
  3. Eat foods high in vitamins A and C.
  4. Drink or rinse with 4-5 cups of black or green tea daily.
  5. Eat tomatoes or tomato rich foods and watermelon (have high concentrations of antioxidant lycopene.)
  6. Have one cup of black raspberries per day to reduce oral cancer.
  7. Eat avocadoes (contain phytochemicals that reduce oral cancer.)

Enjoy Life. Depression appears to make lichen planus symptoms worsen. See a physician if you suffer from depression. Also, blood tests may be indicated to check for vitamin deficiency or autoimmune disorders. Take Multivitamin daily.

Medications that are helpful:

  1. Chlorhexidine (CHX) Mouthwash for one month, 2x daily, then OK to stop, or continue 1-2x per day if it is helping. Brush and floss BEFORE rinsing with CHX. Superficial staining will occur and can be cleaned by your dental hygienist.
  2. Prednisone 20 mg (10 tablets, one tablet am with food for 10 days.) Refill for future severe flares. Call on day 10 to report symptoms. Always use CHX mouthwash when using systemic corticosteroid to reduce risk for developing yeast infection (candidiasis.) After completing course of prednisone, if you still have sores, you can add a topical medication.
  3. Fluocinonide gel 0.5%, apply thin film up to 4x daily to painful areas. Avoid eating or drinking for 30 minutes after applying topical medication. If no results, can try topical tacrolimus or systemic metronidazole.

Unfortunately, no exact cause or cure of Lichen Planus has been documented in the research, so our goal is to control discomfort and flare-ups. Some of our patients have experienced relief with rinsing with coconut oil or rinsing with an Aloe Vera Mouthwash. Also, grapeseed extract (200mg daily for one month) may help reduce inflammation. Please let us know what helps YOU SO we can help others.

Please call us if you have questions:

Family and Cosmetic Dentistry of Kokomo

(765) 453-4369

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