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What triggers Oral lichen planus? This is the most common question that my patients ask. Moreover, this is the toughest question to answer either.
Strictly speaking, OLP has a multifactorial etiology. No single factor is known to play a key role. Interestingly, contemporary research has failed to provide strong evidence for the initiation of oral lichen planus.
Before reading this post I would recommend you have a look at this post for a complete overview of Oral lichen planus.
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What does the research say?
Research says that OLP is a lifelong battle. The principal mode of treatment is to manage the disease.
We cannot cure the disease. We have to manage it
But we can have a robust management protocol only when we know the actual cause. So let’s dig deep into the possible consequences of developing OLP.
Anxiety & Stress
A study conducted by Chaithra showed promising results. The research team found that patients suffering from OLP have high frequencies of psychiatric co-morbidities than the control group.
Hence patients with OLP have to search for psychiatric components in their daily life. People with excess stress are more prone to develop OLP.
Lifestyle modifications and stress management are vital in these people for managing OLP. Timely counseling from an expert at times of stress can help you in preventing exacerbation of the disease.
Exercises like Yoga and meditation have shown promising results in relieving stress. Moreover, a positive attitude towards life and problems helps one to get out of the disease as early as possible. (Remember! OLP is a lifelong disease. We can only manage but not treat.)
Do you know, OLP occurs more in middle and elderly aged women. Many researchers consider OLP as a form of the disease due to the dysregulation of the immune system.
Hormonal changes in perimenopause are known to be an important factor in initiating OLP in elderly women.
Ravi Prakash et al in their research observed that the incidence of oral lichen planus is twice (2X times) higher in postmenopausal women than the general population.
It could be attributed to the role of estrogen and progesterone in causing immune dysregulation, which in turn produces many immune disorders like multiple sclerosis, lupus erythematosus, and OLP.
These hormones may not have a direct impact on OLP but may result in depression, which in turn results in the disease.
T-lymphocytes are immune cells present in the blood. They play a key role in activating both CD8 cytotoxic cells and the B-lymphocytes.
Studies observed deficient production of type 1 & type 2 cytokines in OLP patients. As a result, the activation of CD8 and B lymphocytes is altered, resulting in an altered immune response.
Kalogerakou in his study observed the same and has hypothesized altered lymphocyte activation as one of the etiology for OLP.
Local irritants like calculus, fractured restorations
Lichen planus on gingiva is known to have its etiology primarily from the local irritants like calculus and slime layer on the teeth adjacent to it.
Dentists often advise regular professional cleaning to get rid of such irritation. Such lesions look like borderline cases between OLP and lichenoid reactions.
This article has given an in-depth explanation of triggering factors for oral lichen planus. If you have doubts regarding OLP, feel free to comment below. I love to answer your questions.
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