ORAL MED LP management Flashcards
what is our role as a dental professional, when a pt presents with lichen planus?
must inform pt that it is a potentially malignant disorder - if they notice any changes they must get dentist to check it
ask about other site involvement - skin, scalp, genitals, nails
take baseline photographs
provide smoking cessation and alcohol moderation
treatment for asymptomatic lichen planus?
no treatment required - just monitor 6/12
treatment for symptomatic lichen planus?
match treatment to symptom severity
cant cure lichen planus, it is a chronic condition, must manage
generally, what are types of management for lichen planus?
diet modification (salty, spicy, acidic foods likely aggravate it)
SLS free toothpaste
topical analgesic
topical steroid
regular reviews 6/12
what topical therapy is available for lichen planus management under the NHS?
topical analgesics/ anaesthetics
- benzydamine mouthwash/ oromucosal spray
- lidocaine
topical antimicrobial
- chlorhexidine mouthwash
topical steroids
- betamethasone, beclomethasone, hydrocortisone
what can we manage aphthous stomatitis with but NOT lichen planus?
doxycycline
what presentation of lichen planus is most commonly seen in secondary care?
erosive lichen planus
what management in secondary care can be provided for oral lichen planus?
topical steroids
triple mouthwash
calcneurin inhibitors
systemic medication: short course of prednisolone, DMARDs - hydrochloroquine, azathioprine, mycophenolate mofetil
are you at a higher risk of malignant transformation with lichen planus or lichenoid reactions?
lichenoid reaction
how do we manage lichenoid reactions?
liaise with GMP to cease/ replace implicated medication
consider replacement of culpable restorative material with an alternative
review 3 months to check response to change
