What are the triggers for oral lichen planus (OLP)?

Updated: Sep 15, 2020
  • Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Oral lichenoid drug reactions may be triggered by systemic drugs including NSAIDs, beta-blockers, sulfonylureas, some ACE inhibitors, and some antimalarials. In patients with oral lichenoid lesions, be alert for any systemic drug as a cause.

Oral lichenoid contact-sensitivity reactions may be triggered by contact allergens including dental amalgam composite resin and toothpaste flavorings, especially cinnamates. Skin patch testing may help in identifying contact allergens (see Other Tests). If an allergy is detected, lesions may heal when the offending material is removed.

Oral lichenoid lesions may be triggered by mechanical trauma (Koebner phenomenon) from calculus deposits, sharp teeth, rough surfaces of dental restorations or prostheses, cheek or tongue biting, and oral surgical procedures. Scale any teeth associated with oral lichen planus lesions to remove calculus deposits and reduce sharp edges. Dental restorations and prostheses that are associated with oral lichen planus lesions should be mirror-polished.

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