The one periodontal disease that seems to be increasing in my practice is Lichen planus. This is an autoimmune disease that can be a minor nuisance, a source of significant discomfort, or even a precursor to oral cancer. Generally, there are red and white areas that can be on the gums, tongue or inside the cheeks that may or may not be painful and sometimes have spontaneous bleeding. One hallmark of the disease are white lines called Wickham’s striae, but they are not always present. The disease process is not well understood, but it falls somewhere between an allergy and an overactive immune system, Regardless, anti-inflammatories (generally steroids) are the most effect treatment. Topical steroids are effective for minor forms of the disease, but, in more aggressive cases, system steroids are necessary to get the disease under control. A biopsy is necessary for a definitive diagnosis. There are some studies that show a weak correlation between Lichen planus and oral cancer, and it can be severe enough to cause loss of bone around the teeth and even tooth loss. If you think that you may have Lichen planus, seeing a periodontist for a biopsy is the first step to getting it under control.
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