Log file dec99 for
Chat room Dental_Study_Club
-- Log on dec99 started at Wed Dec 15 14:56:41 PST 1999
...........................Dianne joined............. :)
drburkhart Dianne, how are you? How are things going for you today?
Laur I am an "old-timer" and have been in on many other discussions so I was going to do some "listening" this time!
...........................toby joined............. :)
aupton Laur, you are welcome to do so.
Laur Actually, I do have a question....is there any relationship with excessive itching and LP?
drrees Toby, I'm glad you've joined us. How are things going with you? Is there anything you want to discuss?
Dianne not too bad. just finished another bout with oral yeast but nystatin came to the rescue.
drburkhart Please complete the survey on our page if you have not done so already.
drrees Laur, lichen planus of the skin can itch a great deal. But don't scratch it, that's one way it spreads.
toby Type HERE Dr. Rees: Hello!
Yes, I'd like to ask anyone that might know...What is it about the
cholesterol medications that could have caused my LP? Since I stopped
taking Zocor there has been a marked improvement
drburkhart Dianne, this is a problem that many patients who have lichen confront from time to time. It usually can be controlled.
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Laur Would the Lidex Gel (that I use for my OLP ) help?
Laur ...on my skin itching?
drburkhart Hello Dr. Carpenter. Welcome. I will give you a minute to read the transcript so far.
aupton Dr. Carpenter, you may not be able to see the transcript of discussion before you came on.\
carp Sorry, I am late...
drrees Toby, We really don't know
the answer to your question. Zocor is just one of more than 50 drugs
which have now been identified to cause a lichenoid reaction.
Fortunately, most people don't have that problem. I'm delighted you are
doing better.
carp We had computer problems
aupton No problem. We'll have them all posted afterwards. Welcome aboard.
toby drrees: since I definitely have a cholesterol problem, do you know if there is one that doesn't exacerbate the problem?
drrees Laur, we are a little out of
our territory here but some physicians do prescribe lidex for skin
lesions. The first question that should be answered though is, do you
have lichen planus on your skin or is it something else? You probably
should see a dermatologist to find out.
carp I am unable to read the transcripts that occured before I signed on
Dianne I understand that anything
minty is not recomended but I find Biotene toothpaste has a bit of a
spearament flavor or is it just me?
drburkhart Dr. Carpenter, What new
research is being conducted at your facility? Is there anything that
you want to share regarding the treatment of lichen?
Laur YES, Please!!!!
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carp We are presently not undertaking any new research in LP
drrees Toby, I am only aware of
Lipitor and Zocor being reported so far so there are a number of
different drugs that can be tried.
drburkhart Hello Mary, how are you?
toby Dianne: I've been using just
about every Biotene product including the new mouthwash which I find to
be quite good and not sharp.
Laur Why not, Dr. Carpenter?
Laur Funding?
carp There is presently no funding available for this kind of research
Laur Is there anything that we can do?
Mary I had trouble getting signed
in. I was very excited to find this site a couple of weeks ago. I have
had Llichen Planus in my mouth for over 5 years and have had trouble
finding information.Type HERE
drrees Dianne, some people should
not use mint but the number who react to that is far less than those
who react to cinnamon. We have not yet seen anyone who had a lichenoid
reaction to Biotene.
toby drrees: have you heard of benechol? supposedly, it is a new cholesterol inhibitor.
Dianne laur how old time are you as far as LP
Laur I have had olp for about 6 years....
drburkhart We have had over 14,000
hits on our site since we began so there are many interested patients
out there as will as practitioners. The research will follow I am sure.
We do have many good researchers that do conduct ongoing studies on the
cell-mediated response.
carp Perhaps forming an LP group similar to the sjogren's group or Paget's
drrees Toby, I am not familiar with it but your physician can advise you.
carp group where large numbers of patients can demand government funding in this areas may be helpful
Laur Who do we contact?
Mary I have found through
experimenting that tomato products, fruits, chocolate, spices irritate
the tissue. My mouth has never stopped reacting since it started. My
dentist says that I have a particularly aggresive case. I ask every
medical person I come in contact with for info. Everyone has studied
about it, but no one has had a patient with it. Makes you feel odd. I
would like to know how to lessen the swelling of the tissues.
carp perhaps the formation of an LP group could be started on this chat room
drrees Toby, I believe it is important to control your cholesterol so please pursue that.
drburkhart We would like to expand
our research efforts here at Baylor and we hope that this site will
provide some evidence of the need for such reseach. We also hope to get
some good info from our survey that you all have completed on the site.
toby drrees or drburkhart: My MD
prescribed Kenelog paste for the lesions that I had and that seems to
have helped clear up some of the lesions. Is there a great difference
between Lidex and Kenelog?
Laur Maybe we need a convention! : )
drrees Mary , there are some items
of information about LP and its treatment that might be of interest to
you regarding its treatment.
toby drrees: I see the MD again on
Monday of next week and expect him to give me something other than what
I had taken. I also have eliminated everything that contains
cholesterol that I possibly can from my diet.
Laur Toby, have you tried Niacin?
drrees Toby, Kenalog works fine for
some patients. Lidex is stronger and therefore we have better results
with it. However, if Kenalog in Orabase works, keep using it.
Mary I am disappointed. I thought
that this showed that research was being done. I have asked my doctor
if some of the drugs I am taking could be causing the lp, but he didn't
think so. I take Lipitor, Dolobid, Propranolol.
toby Laur: Not in any isolated form. I do take multivitamins that contain Niacin
Mary drees: what are the items of info and how do I obtain them?
Laur I take 400 mg. daily (under a doctors care) to keep my cholestrol in check...
drburkhart Dr. Carpenter, What is the recommended types of meds. that you use at your facility?
Dianne I was diagnosed by biopsy in
1978. I would be interested in a convention or furthering this group
somehow.diannedoucette@hotmail.com
Laur You might want to ask your doctor about it?
toby Laur: Thanks. I'll mention the niacin to him.
drburkhart Mary, we have several pages of info on lichen planus found on our site. Just go to the individual page.
Dianne what is the difference between lidex and dermovate
drrees Mary, contact us later at
our web site and I'll try to get you a list of drugs that may cause the
problem. However, I think we should all be aware that usually it is not
drugs that initiates the LP. Unfortunately much of the time we don't
know the cause.
drburkhart Mary, We would like to continue to expand the site and have more of the sessions also.
carp our normal medication for
erosive types of LP are lidex gel or mixed with orabase. Other types of
steroid are dexamethasone elixir or temovate. If these do not work, we
go to a systemic steroid pill such as prednisone.
Mary drburkhart: Yes, I have
already done that. I guess I'm looking for a solution. I worry about
developing cancer, or about the lp spreading and getting worse than it
already is. It's hard to believe that something that's been around so
long has no known cause.
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Dianne what is orabase???
drrees Dianne, temovate is a bit
stronger than lidex. We prefer lidex first for a number of reasons to
include increased susceptibility of developing oral candidiasis.
carp it is an ingredient of a
gelatin type product that adheres to the oral mucosa, and therefore is
a vehicle for carrying the active steroid ingredient and keeping it in
contact with the mucosa.
drburkhart Mary, there may be many
trigger mechanisms and as you know everyone is different. Lichen planus
is a chronic condition and I truly believe that the stress factor is a
strong element regarding the severity. As you know, many diseases have
an association with stress. As I said there are many researchers
conducting studies on the cellular function of lp
Mary When my lp was at it's worse
was after I had alot of crown prep work done and my tongue swelled, etc
and I panicked because it felt like I couldn't swallow. Lidocaine
solution gave me some temporary relief so I could eat a little. I also
had some Triamcinolone paste for awhile and use Dexamehtasone Elixir.
The greatest find was the Biotene toothpaste.
drrees Mary, your comment about the Biotene is interesting. What kind of toothpaste were you using before?
Mary What is the best way of
identifying the trigger mechanisms for an individual. I have noticed
that the same things that irritate my lp also must bother my stomach as
I get heartburn. Would this indicate a general sensitivity?
drburkhart Mary, yes recommend
Biotene to the patients here at the stomatology center. Most improve
when they discontinue the more abrasive forms.
drburkhart Mary, lichen planus may
occur in any of the lining mucosa. Therefore, you may be right in the
association and you also may have several problems going on at the same
time. I think that keeping a diary of any associations is always
helpful.
drrees Mary, you can usually
identify the triggers by whether or not it burns when you use it or put
it in your mouth. There should be no direct connection with your
hearburn except that hearburn may cause acids to get into your mouth
and make if even more sore.
carp Mary, what is the irrtiant for your oral LP and your heartburn?
toby I have found all of the
Biotene products helpful. The toothpaste is especially good as is their
mouthwash and chewing gum. The gum is great during the day to help
"sweeten" the mouth.
drburkhart Toby, what did you use before?
Mary I tried everything I could
find without mint, but they all hurt. Biotene stings a little, but is
tolerable. I didn't understand why it wasn't recommended right away. I
had a biopsy by an oral surgeon who sent it to the U of Indiana for
confirmation. He was very understanding, but I was extremely stressed
that there was no cure or known cause. It seemed to come on so suddenly
that I was and still am sure there has to be something more direct. I
started showing signs of
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aupton Mary, your comments are getting a bit to long for the server program. You may send parts of the message individually.
toby drburkhart: Since I have full
dentures I usually would brush them with a denture toothpaste and then
soak them in efferdent. I would then use Scope mouthwash. My routine
now is to brush them with Biotene in the morning, as well as brushing
my gums with a supersoft brush and then at night I soak them in
efferdent and again brush the gums with the Biotene. It seems to work
for now.
drburkhart Mary, we here these
comments from most patients who have chronic disease. This is most
difficult for patients to deal with because of the fact that in today's
world we want and expect a diagnosis and a cure.
drrees Mary, the end of your
message did not print. Anyway there is an even milder toothpaste on the
market now called First Tooth. It is probably too bland for most of us
because it was designed for infants. However, it might be good to try
if Biotene burns.
Mary carp: irritants are citrus
fruits, tomatoes, spices, hot(temperature), chocolate. All milk
products are of course wonderful. Ice cream is especially soothing
because it is bland and cold. However, I have a weight problem, so I
shouldn't be enjoying that.
............................Dianne left ............. :(
carp Mary, your irritants are
mostly acidic in nature and probably exacerbate the pain in LP rather
than being a cause. However, it is also possible that you may have an
allergic reaction to certain foods and spices and probably should avoid
these if possible.
drburkhart To all: how often is you Lp evaluated by your dentist?
Mary drrees: I will try the First Tooth. I'll try anything!
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Laur During regular dental check-ups.
drburkhart Mary, were you tested for allergies initially?
Mary My dentist evaluates my lp everytime I see him. Unless I'm not understanding to what degree you mean.
Laur He doesn't really evaluate it....just comments on how it is doing...
Mary No I have never been tested
for allergies. But I am sensitive to lots of things. I have been taking
Allegra also this year.
toby I first noticed the problem in
late August when I developed the first lesions and had my dentist take
a look at my dentures thinking I was getting an irritation from them. I
haven't been seeing the dentist unless my dentures bother me
drburkhart Do any of you have photographs taken periodically?
Laur no
carp Mary, what type of MD is prescribing Allegra to you, and for what illness is it being prescribed?
toby No
Laur I haven't ever had photos taken..
Mary My dentist takes photos frequently. I hate it, because it means more messing around in my sore mouth.
drrees To all: since our group
seems to be all female tonight let me remind you that recent evidence
indicates that vaginal lichen planus has bee found to be associated
with oral LP on occasion. If you haven't already done so you should get
a gyn evaluation.
Mary Allegra for sinusitis
toby carp: My MD prescribed Allegra when he changed all my meds after being told about the OLP
Mary Vaginal lp sounds really scarry. I had a pap smear several months ago with my physical
drburkhart Mary, this is good. It
is much easier to evaluate the changes that sometimes occur with the
photo and a good written statement describing the lesions.
toby carp: (I hit the enter button by mistake) The MD felt that it might help as an antibacterial (I think)
Mary I forgot to answer the rest of your question. My MD is an internest, but I go to him as a GP
Laur My dentist seems almost disinterested in my OLP....
drrees Dr. Burkhart will be
presenting some information about oral/vaginal LP gathered from the
survey which is on the web site. She will present this in March at a
research meeting.
carp Toby, allegra is an
antihistamine drug and useful in non-infectious types of sinusitis (hay
fever), but not as an anti-bacterial drug. It is also used for various
allergies.
toby I have a regular physical
every year that includes a PAP smear and have never had any indication
of LP. My last PAP was done after the OLP diagnosis.
Mary The hygenist at my dental
office told me she read that it is now thought that many cases of
gingivitis are really early cases of lp
Laur Would vaginal lp show up on a PAP smear?
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drrees Laur, not necessarily but it would be evident on a visual exam.
drburkhart Laur, please tell him
about our site. We would like to have a session for any practitioners
who would like to discuss the topic of LP. We may do this after the
first of the year. I think that this would be helpful to everyone.
carp I do not believe that vaginal
LP would show up on a pap smear, but most cases would be symptomatic
with episodes of burning and discomfort.
Laur Great!
drrees Mary, I think what your
hygienist meant is that we have often mistaken LP for gingivitis in the
past. Most gingivitis is still caused by plaque.
toby carp: I understand what you
are saying but he felt that it might be of some help in controlling any
allergic reaction involved inLP I meant antihistamine, not anti
bacterial
Mary I had some toenails removed
(ingrown) and I had some granulated tissue form first. The podiatrist
said that that is also very rare
Mary Yes that's what I meant about
the gingivitis. I was treated for it for several years before it
worsened and then all of a sudden it was LP
carp Toby, anti-histamines are not
useful in oral LP for this is a different type of allergic reaction if
it is associated with direct contact. The medication for this type of
an allergic reaction is a steroid preparation.
drrees Mary, I'm not sure what you
are asking but LP can affect the nails(usually the fingernails) on some
occasions. I doubt that you had that from of LP however. It sounds like
a reaction to the ingrowh toenails.
Laur I've got to go...thank you for your time doctors!
drburkhart Thanks, Laur.
Mary I was interested in one of the transcripts that said that some dental filling materials are suspect
............................Laur left ............. :(
drburkhart Mary, we have some good
literature on this subject. Would you like some articles? email me and
give me your mailing address if you do.
Mary I just thought it was interesting that I have had more than one thing that I was told was "rare" happen to my body
toby carp: I think he knows that,
but I will let him know what you have said. He knows that I am joining
in with this chat group. Maybe I can get him to join in the next
session. He seemed quite interested in the transcript of the last one.
carp Mary, there have been reports
of lichonoid reactions occuring due to metals used in filling teeth.
However, these are usually in direct contact with the oral mucosa
rather than a generalized reaction.
Mary dr burkhart: I would love some articles I will email you Thanks alot!!!
drrees Mary, we are in the process
of gathering some data about reactions to filling materials. In Europe
that appears to be relatively common but in our clinic we don't see
many patients reacting to fillings with LP .
Mary It just seemed that the lp worsens after dental work. After I had crowns(gold) put in is when it was diagnosed
toby Anyone: How often does LP in
any of its forms lead to cancer. One of the cautions I was given with
the original diagnosis by the Oral Pathologist was regarding cancer. He
told me to be sure to contact him in a year for a checkup again and
immediately if I notice any real change in my symptoms.
drburkhart Dr. Carpenter, What is the percentage of lichenoid reactions seen in your clinic?
drrees Mary, an allergist can check you to see if you are allergic to any of the filling materials including gold.
carp Mary, gold is very rarely the
cause of an allergic reaction and if it is, more than likely you would
react to gold jewelery that you wear next to your skin.
drburkhart Toby, any lesion in the
mouth should be followed and evaluated closely. With chronic
conditions, it is very important to monitor for any tissue changes.
aupton Folks, we have about 7
minutes left in the session, after which the doctors will need to
leave, and the room will be closed. Please get your final messages
ready.
carp Dr. Burkhart, we do not have a
good sense of the number of our lp cases that are actually a lichenoid
drug reaction, but see a number of these cases in our biopsy service.
Very commonly it is a reaction to cinammon. these are often difficult
to differentiate on a histologic basis.
drrees toby, your question is hard
to answer because some forms of LP seem to be more closely associated
with cancer. The percentage is very low. For example, in our clinic
where we see patients with very severe forms of LP less than 1%
experience even precancerous changes. However, that is one reason why
its important to have periodic checkups if you have LP.
toby Believe my, I will be back to be checked often!!! This has been most informative. Thank you!
drburkhart Toby, good. Certainly, if it happens to you, it is 100%
aupton 5 Minute Warning. It's been
a good one, and we appreciate everyone's participation -- The Session
transcript for this evening's session will be published by tommorrow at
http://www.tambcd.edu/lichen
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drburkhart Thank you for the
participation tonight. Please email us with your suggestions for
improving and for adding information to the site. This is for your
information and we want to help all you in the best way possible.
drrees Carp, Bill I haven't had a
chance to say hello to you yet so hello! We greatly appreciate you
being willing to join us. It,s fun isn't it
carp Hi Terry, hope to see you in Washingtlon
carp sorry, Washington DC in the Spring. Best wishes to all of you down there for a wonderful holiday season.
drburkhart Thank you for bing with us Bill.
aupton 2 minute warning -- When you have finished, please click the Log Off button at the top of your screen.
carp Good bye.
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drrees Mary, I think you are the
last participant left so let me thank you for joining the session. I
hope it has been of some benefit to you.
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aupton Mary, the doctors have left.
I'm about to close the room. The session transcript will be posted in
the morning. Good night.
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-- Log stopped at Wed Dec 15 15:58:24 PST 1999
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