| .............. Log on feb01 started at Tue Feb 13 14:11:29 PST 2001 ........... | |
| Jan | I have found that enamelon toothpaste (recommended by my dentist) is mild during an LP breakout |
| DrSiegel | DID WE WEAR YOU GUYS OUT??? |
| Mia | what else could be like oral LP but without anything on the arms and legs. I have been biopsied for cancer . |
| Dev | what about recommending chlorhexedine to my patients? |
| DrRees | Dot- That is probably the most common site for oral LP even though it can occur anywhere in the mouth. |
| jp | I use Enamelon also...can't use regular toothpasre...am feeling good |
| Laur | Where can you get Enamelon? I haven't seen it locally. |
| DrSiegel | I like Enamalon. I always suggest a mild tooth paste without Tartat Control formula (pyrophosphate), sensitive tooth formular (potassium nitrrate) or antibacterial formula (triclosan) as these chemicals can be irritating |
| fb | Biotene Toothpaste works for me--when nothing else does. |
| drburkhart | JP, we continue to see that stress does appear to make the condition worse in many patients. During the holidays and during times of personal stress. Patients who alter life styles and reduce stress appear to do much better. More and more research appears to support this element. |
| Lou | Are there any major studies being conducted for LP? |
| jp | In a regular supermarket |
| Laur | thx |
| DrRees | Dev-I would only do it if they are having a problem with plaque control. Then they should follow the rule, if it burns, don't use it. |
| Dev | ok how about povidone iodine for plaque control? |
| Lou | I use a desensitizing toothpaste, if I don't I cannot deat citrus or other fruits. |
| jp | How often should we get rebiopsied |
| ang | I developed my lp immediately after surgery. is there any connection with tools for intubation? |
| drburkhart | Biotene toothpaste is the choice in the stomatology center-usually any patient can use this product. |
| Jan | Rebiopsied? Why??? |
| sh | what is involed in a biopsy of oral LP |
| DrRees | Dev- it is a great antimicrobial but it's effects wash out very quickly. That is the advantage to cholrhexidine |
| DrSiegel | Major medical centers such as Johns Hopkins are always looking at new ways to treat disorders. As far as protocols specificiaclly looking at OLP, I am under the impression that a number of dental centers such as NYU are considering LP protocols at this time. |
| jp | Because you have to keep an eye on the situation...don't you |
| moni | any suggestions on the mouth surgery ?? or did I miss it |
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| Laur | I have only had one biopsy and that was 5 years ago... |
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| ruth | Has anyone noticed any connection between latex allergy and lp? |
| dot | Doestne mint in Biotene toothpaste cause a problem? |
| Jan | My surgeon has never suggested another biopsy, should he? |
| Lou | I believe that my LP was as a result of my gum surgery I had, is that a possibility? |
| jp | Dr. siegel...do you recommend periodic biopsies? |
| Dev | does sodium lautyl sulfate or any other compound in regular tooth pastes aggravate the condition? |
| fb | If I have lp on hands and ankles, as well as oral lp, would I looks to different causes than I would for just olp alone? |
| Di | How long does this disease usully last? |
| DrSiegel | Laur...there is no clear cut rule for how often to rebiopsy. If the lesions are red (erosive) or ulcerated, they may require more frequent biopsy |
| drburkhart | To everyone: We can only see the screen in part and if we answer a question, we may miss someone else. So, keep asking your question and eventually we will answer. |
| DrSiegel | Thanks Dr. B |
| DrRees | ang- Your thought about intubation is intersting. Sometimes those have latex in them and can cause an allergic reaction but I am not aware of latex causing LP. |
| fb | c'mon Dr S--pick it up!! |
| DrSiegel | As far as mint flavoring, any of the flavors with an oil base can potentially be a problem, so stick to fruit flavors which are water soluble |
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| Mia | Can LP be caused by certain kinds of anesthesia or by "the wand" used for novacaine delivery? |
| ruth | Thanks! I'll ask again. Any connection between swelling of the tongue and lp? |
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| sh | What is involed in a biopsy of oral LP |
| drburkhart | Di: some individuals may only have lp for week while others may have an ongoing problem. There is no way to predict this for anyone. |
| DrSiegel | fb your next vist will cost you twice as much....for heckling as you promised!!! |
| DrRees | DI- No one knows the final answer to that. Skin LP usually goes away fairly quickly but oral lesions can persist for years if not treated. |
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| Jan | I also have swelling of the tongue from time to time - any connection? |
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| DrSiegel | Jan: Are there lesions on your tongue? |
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| Jan | Yes, from time to time. Mostly inner cheek |
| JoeUK | ang - i noticed you said that you had been diagnosed "w/o biopsy". I was in a similar position for the latter part of last year (diagnosis w/o biopsy from my general dentist). When I finally saw a specialist and had it biopsied it turned out to be something completely different, and less problematical than olp.... So for me a biopsy was well worth having |
| ruth | i don't know about Jan, but I have both lesions and swelling on the tongue. |
| dot | I developed L P at the same time I found I was allergic to Latex. I suspect a link. Is there |
| DrSiegel | Usually, lp does not cause the tongue to swell. Could the swelling be related to a medication you are taking. |
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| Dev | regarding the time for which it stays are there any recommendations for long satanding cases? |
| DrRees | Ruth- It is certainly possible that severe inflammation can cause some swelling but tongue swelling itself is not a recognized condition associated with LP |
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| jp | I have swelling of the tongue when a flareup is happening |
| drburkhart | Joe, thank you for letting others know this-very important point. You do need to know what you are treating. |
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| ang | any doc, I was diagnosed w/o biopsy. I have white linear buccal marks , permanent white patches and temp red sore patches on my tounge I also have small linear raised marks on my lower legs. Are these symptoms typical of lp? |
| DrSiegel | LP is often related to some sort of hypersensitivity reaction or altered immunity. While I am not aware of LP specifically related to latex reaction, my instincts suggest that they could be related |
| Dev | i mean i ahve a couple of cases with severeOLp whose disease just wont go away! |
| Mia | What if doctors disagree as to diagnosis, even with biopsy results? |
| JoeUK | you're welcome, dr burkhart |
| Jan | I always wondered if there was a connection with taking estogen and LP. |
| DrSiegel | ang yes. but without biopsy, I would not feel comfortable treating you long term without a definitive diagnosis. You can be biopsied from either the skin or the mouth or both |
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| kv | How are most OLP patients being treated? |
| Dev | I have this problem especially with cases having OLP involving the gingivae |
| DrSiegel | Lichen planus has a very specific pattern under a microscope. Some pathologists are more picky about this diagnosis than others and may use the term lichenoid mucositis if the pattern is not exact |
| DrRees | Dev- Usually you can control the LP enough to make the patient comfortable or even make the lesions go away for a time but they tend to recur. There doesn't appear to be any major harm to the long term use of topical steroids such as lidex. We don't know for sure about the strongest topicals but after several years we have not had patients with obvious adverse effects. |
| Lou | Are you saying that I shouldn't use desensitizing toothpaste? Then what do I use. |
| moni | jan I've ben on estogen for 30 years maybe thats where I got LP |
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| sh | is there a connection between olp and taking sulfameth/trimethop |
| drburkhart | Jan, Lp does appear to be greater in post menopausal women, but from what we see in our survey statistics, it is not related to hormone replacement therapy. Would Dr. Rees and Dr. Siegel agree? |
| Di | Have any of you prescribed Tegison (etretinate)? It temporarily cleared up my problem |
| jp | I use orabase with fluocinolone...it worked |
| Laur | .Lou, I use desensitizing toothpaste too....my dentist says "no problem" |
| ruth | the oral surgeon who did my biopsy suggested lidex. My doctor said that lidex isn't used orally...what should I say? |
| ang | what are the symptoms of vlp |
| Dev | is it ur experience that OLP is more difficult to treat in Post Menopausal women? |
| Di | However, I had some awful side effects (and it was very expensive)> |
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| dyuill | Good evening everyone, I've just had my 16 month old OLP confirmed via Biopsy |
| DrSiegel | Lou. use a mild regular formula tooth paste. The potassium nitrate in this tooth paste essentially scars the dentinal tubules to mininimze the flow of fluids in the dentinal tubules in order to make the root of the tooth less sensitive. Use of a mild tooth paste with fluoride will help with the sensitivity and will not be as caustic to your soft tissues |
| DrRees | Dev-I think that is common since the gums take such a beating from chewing, brushing etc. However, if lesions are confined to the gingiva you might be more suspicious of a toothpaste reaction or allergy to a dental material. |
| ruth | ang-incredible itching! |
| ang | how is vlp treated |
| drburkhart | dyuill, please give us some details about your case. Welcome! |
| Dev | i havve had an awful time treating one such case would u recommend trying putting her on hormonal replacemnt therapy? |
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| DrSiegel | Ang...this is the million dollar question. It depends if a culprit can be identified, for example, a spice in your diet such as cinnamin, a medication such as HCTZ (a diuretic). If no identifible trigger can be identified, the use of topical steroids is where I usually begin |
| Dev | well as a ageneral rule id reccomend to all my patients is to try quitting toothpaste use for the short - term it still poses me a problem i mean the gingival OLP |
| dot | Is there a list of foods that I should never eat again to keep my condition under control? |
| DrRees | Dev- You are asking some great questions. LP is far more common in post menopausal women than any other group so it is hard to say it is more resistant to treatment. It has not yet been possible to connect the OP with hormonal deficiency, however. |
| drburkhart | I would like to make the point that we are seeing many patients who appear to have some signs of vaginal/genital lp that sometimes are not being evaluated as possible lp even when there is confirmed oral lp. |
| Jan | I use fluocinonide Gel 0.05% and apply it with a "Q" tip. Any other ideas? |
| dyuill | Well, I was initially diagnosed with an oral infection including strep-A which was treated with Antibiotics, I also had a fungus growning in my gum plaque as well as ameoba! |
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| DrRees | Jan- sounds good. Just try to avoid vigorous rubbing when you apply it and it may be best to dry the area before you do. |
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| drburkhart | Dot, we get surveys from many patients with all sorts of foods that appear to cause problems, but generally if the food causes you some discomfort, then it is best to avoid that product. |
| moni | Dot My question also are there some things I should never eat?? |
| ruth | can olp cause sore throats? |
| jp | I use my finger to apply the fluocinolone...dentist said to do it that way |
| Laur | spicy foods! |
| dyuill | I'm now taking a systemic antifungul (fluconizol) which seems to be effective, ie: I've cleared all my secondary symptoms, only the OLP is remaining... |
| DrSiegel | Dot...the foods list is empiric as there is no proof that changing any of this makes any difference. However, studies with canker sores have implicated chocolate, some nuts such as walnuts and some spices such as cinnamin. I am especially careful of cinnamin because there have been reports of lupus-like lesions which clinically mimic lichen planus. Also NSAID medications such as Motrin and Ibuprofen (OTC) have been reported to cause licheniod reactions |
| ang | I have had mild lp ( minimal pain) for about 7 months will it typically worsen? |
| kv | garlic always causes a flare up for me |
| Lou | DOES ANYONE FEEL THAT SURGERY TO THE GUMS COULD CAUSE THIS PROBLEM WITH LP? |
| Mia | and ginger! |
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| drburkhart | Ruth, we have had at least four patients contact us in the last few weeks with possible lp in the throat. Many ent patients will tell you that they do see this from time to time. Sometimes this is not conncected with lp. |
| DrRees | Ruth- On rare occasions LP has been found in the throat but it is not common. When that occurs one usually requires systemic medications to treat it. |
| DrRees | Lou-No |
| ruth | I have used Nystatin in the past. Would that help? |
| kv | What are your drugs of choice in treating OLP |
| jp | I have it in the throat,...talked about it in a previous chat session...went away with the rest |
| DrSiegel | I often use the analagy of having a paper cut on you finger and placing that finger in alcohol. IT WILL BURN!! However, place an uncut finger in alcohol and it will not burn. Therefore there is a difference between what will trigger lp and what will aggrevate it |
| drburkhart | Please everyone, if you do have a sore throat and you have lp, don't jump to the conclusion that you have lp in the throat, but it does happen. |
| fb | For a real Plata Mexicana, the systemics would be worth it! |
| don | Type HEREIs anyone doing research on the genome association with OLP? |
| dot | After brushing with Biotene, I tend ti feel week for a little while, is this a sign of a chemical |
| DrSiegel | In 20 years, I have only seen one case of lp of the throat and one case of lp of the esophagus. It is rare |
| Lou | How long do you use the topicals before you would expect relief? |
| dot | reactionin my body? |
| DrRees | ang- Not necessarily if you are treating it. Once it is under control you may be able to stop treatment and restart early if you get recurrence. I had much rather treat mild Lp than wait for it to get worse. |
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| Dev | has arthritis i mean the basic pathology part of it just like a past history of Hepatitis got any to do with OLp I undersatnd antiarthiritics will aggravate the condotion |
| dyuill | I'm also taking Nystatin and it's been effective in treating my secondary infection which was taxing my immune system. |
| sh | is there a list of known medication that trigger LP |
| Laur | Is there a typical composite of the LP sufferer? |
| DrRees | dot- I don't think a reaction to Biotene would cause you to fee weak. |
| moni | DR Seigel IS ANY RESEARCH BEING DONE ON ORAL LP ? |
| DrSiegel | fb is giving me heat because I just got back from a week relaxing in Mexico. And he is correct, if the lp is really stubborn, 10 days of prednisone will give you great relief and help you dr find areas which are not steroid responsive |
| ang | I am currently taking synthroid for a total thyroidectomy. I was told not to take steroid while on the med because it would interfere. Is this the only systemic remedy? |
| drburkhart | sh: we have a llist and if you contact us after the session, we will send you one rightt away. |
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| fb | Who is the "senior sufferor" here? I'm passing two years, but I sense I'm junior in this group. |
| Jan | Gee, I take synthroid also - is there any connection between that and LP? Which medications worsen this condition, please |
| Laur | 5 years... |
| DrRees | Dev- There may be an association with arthritis but there is not yet enough evidence. As you indicated the medications used may cause a lichenoid reaction. |
| Lou | I'm approx 23 years. |
| Laur | whew |
| jp | 1 year |
| moni | 3 years |
| DrSiegel | Moni: As I said earlier, the dermatology journals always report new ideas for treating lp. on the skin, they are using PUVA therapy which is a drug taken orally and then a light emiting ultrviolate A (like from the sun) is placed on the skin. Hopkins is trying a PUVA light in the mouth, but I have not yet heard of any results |
| kv | Diagnosed 20 years ago. Has only been active 4 years |
| Dev | what do we do in cases that do not respond to topical steroids i find that usuaually happening in gingival Olp |
| dyuill | Here's one I bet no one has heard before, I've found that taking "Complex Banlangen" Tablets from the Chinese pharmacy DRAMATICALLY reduced the swelling of my gums!!! |
| moni | THANK YOU DR SEIGEL |
| DrRees | Jan- So far a connection with synthroid has not been reported. Many, many of our patients are taking synthroid but so are age and sex matched control patients. |
| mare | Over 16 years |
| DrSiegel | dyuill...never heard of that...be careful, coincidence??? |
| drburkhart | I would like to stress the importance of the information that we get from our surveys and encourage everyone to complete the survey if you have not already done so. We gather much demographic information from these forms. The support group is becoming very international and the information is valuable. |
| dot | I would like to be part of the support group. |
| ang | is the steroid you recommend topical or systemic |
| aupton | dyuill and others -- Specific recommendations should come from the doctors. We'll have a chance to share emails toward the end. |
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| Laur | Has there been an increase in the incidence of LP? Could it be from our environment possibly? |
| kv | Does there seem to be any particular part of the world where OLP is more previlent |
| jp | I would still like to know if drs. recommend biopsy annually or every 2 years?? |
| DrRees | Dev-It depends on the strength of the topical steroid. If you have tried the most potent topicals then you may need to prescribe short term (2-3 week) systemic steroids. Topical cyclosporine has also worked for some patients. |
| Lou | All I know is that I am very frustrated with this condition and I don't want it to turn ugly. |
| drburkhart | dyuill, what is the ingredient of the tablets? |
| moni | are there any group meetings in person anywhere in the states ?? |
| Laur | It is a frustrating condition, Lou! |
| dot | Can it hurt to use A na D ointement on vaginal lp? |
| DrSiegel | SOmeone asked about drugs. There are 30 or so reported medications which have been associated with lp. I suggest that you find a PDR (physicians desk reference) and look up each of your medications. Look at the section on adverse reactions and then find the section on Dermatologic (skin). If the medication causes lichen planus or lupus like reactions on the skin, it can also do it in the mouth. Common drugus are diruretics (HCTZ, Lasix) tetracyclines (vibramuycin |
| jp | When it flares ,only those who have it can appreciate how awful it is!! |
| dyuill | Radix Isatidis 50% Herba Taraxaci 25% & Herba Violae 25% |
| DrRees | kv-Most of the studies have been conducted in developed countries. However, several reports suggest it is common in India. Not much from other parts of Asia or Africa but that is probably due to lack of studies. |
| Mia | A doctor told me it was more prevalent among people of Jewish origin |
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| Lou | So do you suggest that I - we be tested for alergic reactions to fillings etc????? |
| drburkhart | Laur and Moni: we hear this everyday and I feel that support groups for chronic conditions are very important. LP is a chronic condition and patients tend to feel isolated and confused. The sessions such as this one give each patient the sense that they are not alone. |
| Lou | Anyone know of a support group in ontario, Canada?? |
| dyuill | Has anyone had success in using minute does of "caustic potashe" ? |
| ruth | I have been diagnosed by biopsy for olp. A dermatologist diagnosed the lesions on my arms and hands as lp, and my MD diagnosed vlp, but not by biopsy. Do I need to be treated by two or three different medical professionals, or could one treat all of my symptoms? |
| DrRees | Mia- some diseases are but not necessarily LP |
| DrSiegel | I do not know of any histocompatability antigens that make it more common among jews. That is true for pemphigus vulgaris and crohn;s disease, but, to my knowlege, not lp |
| Mia | Any other mouth diseases that are? |
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| Dev | I am really concerned about gingival Olp as i said I am Dr Devinder Kalsi - Periodontologist -- I am in regular contact with Dr Burkhart on this but i guess this chat has opened up a great opportunity to get tough querries answeres live! |
| Lou | What is leukoplakia?? |
| dyuill | Lou, I'm in Ottawa, email me if you want! |
| DrSiegel | Dr. B I completely agree. I see so many patients whose first question is, "have you ever seen this before." YOU ARE NOT ALONE!!! |
| Jan | These sessions have helped me tremendously. |
| don | May I assume you don't think olp has a genetic nature? |
| DrRees | Ruth-If you had to pick one you probably should pick a dermatologist. However he/she will need to confer with the gyn and oral medicine specialist at least from time to time. |
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| fb | There's a group of doctors(?) in India that show up in the internet searches who profess a treatment. Is this as flakey as it sounds, or is there something there? |
| ang | if you did have an allergy to a filling and you remove it will the lp go away or will it still need to be treated? |
| Lou | Sure, I would like that. How do I get your ID |
| Dev | any specific studies on Gingival lesions? are they available? |
| DrSiegel | Leukoplakia, in latin is white patch. The World health organization defines this as a white patch, which does not wipe off where there is no other identifyable diagnosis. Therefore, lichen planus, once diagnosed is not a leukoplakia |
| DrRees | Dev- I too am a periodontists. Look up my phone # in the directory and give me a call. Maybe we can discuss this in more detail that way. |
| drburkhart | IMia, I believe that the study that he may be talking about was on pemphigus and that study was conducted in a predominately Jewish are so there may have been some problems there. For some reason this is cited over and over again. |
| DrSiegel | Is Dr. Rees really a gum gardner??? |
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| DrRees | Dr Siegel-you got it! |
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| DrSiegel | If I could spell, I would be dangerous |
| kv | What are your feelings of Plaquenil versus Prednisone as treatment? |
| Jan | Chlorhexidine stains my teeth, will anything remove the stain? |
| Dev | well calling u Dr Rees would be great cAn I have ur e mail after this session through Dr Burkhart I practice and teach dental students In INDIA |
| jp | How can we contact another member of this group? |
| Woodwomnz | I'm hoping you can give me an alternative form of treatment from medicines for lichen planus ...... I prefer a more natural remedy to control it if possible ........ any suggestions? |
| moni | kv YES YES |
| DrSiegel | Plaquenil is a commonly used drug for rheumatoid arthtitis. I do not usually use this medicication for lp, but some dermatologists do |
| Lou | dyuill let me know how to contact you. |
| dyuill | as@magma.ca |
| drburkhart | Joe, I am so happy that you got a diagnosis and that you are well. |
| DrRees | kv- Prednisone has been used longer and we know more about that. However, I hate systemic steroids and hope that plaquinil will prove more effective. So far there is little to indicate that and it also has side effects. |
| Lou | Thanks - mine -sqeege@sympatico.ca |
| jp | ang... I would like to talk to you more about thyroid and OLp |
| drburkhart | Have any of you tried stress management, yoga or relaxation techniques? Did you have any success? |
| DrRees | Jan- Your dental hygienist can polish the chlorhexidine stain away without too much trouble. |
| dot | How often does lp turn into cancer? |
| kv | My first line of treatment was Prednisone. After developing cushing syndrome was put on Plaquenil 2 years ago and it has done a GREAT job with few side effects |
| DrSiegel | CAREFUL, CAREFUL, CAREFUL.....ASBESTOS IS ALSO NATURAL AS IS DIGITIALIS AND STEROIDS. UNLESS YOU KNOW THAT THIS HERBAL MEDICATION HAS NO SIDE EFFECTS SUCH AS BEING CARCINOGENIC AND UNTIL YOU HAVE SOME CLUE HOW IT MIGHT WORK, DONT SIMPLY SAY..."IT IS NATURAL SO I WILL USE IT!!!! |
| moni | i've been taking Prednesone off and on 10 days at a time for a year and it doesnot ! help me |
| ang | If your lp was caused by an allergic response to a filling will it go away if the filing is rmoved/ |
| DrRees | Kv-Great! There are other reports supporting that. |
| ang | jp what would you like to know about thyroidectomy |
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| JoeUK | Dr Burkhart, thank you. It was obviously a great relief to be given the all clear! I feel humbled by some of the folks here who have been dealing with this condition for so long. |
| kv | Did anyone answer the question concerning OLP and oral cancer. I missed it. |
| drburkhart | Dr. Siegel: Good Points about natural products. We get many inquiries about this subject. |
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| jp | ang.. I also had surgery and the OLp appeared around that time |
| DrRees | ang- Almost always. However there are a few studies which suggest that occasionally lesions only improve rather than totally disappearing. |
| don | Please commen t on avoiding Sodium Laurel Sulfate a.k. Sodium Dodecal Sulfate |
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| moni | DR BURKHART OR SIEGEL any suggestions other than Placcquenil ? |
| DrSiegel | Moni: there are other alternatives. Your dentist or physician might add another medication to the prednisone such as Imuran to cut in half the necessary dose of steroids and therefore minimize the side effects (steroid sparing effect) |
| Jan | I'd like to hear the answer to the question about LP and oral cancer |
| Dev | yes any thing on sodium lauryl sulfate? |
| aupton | ABOUT 15 MINUTES TO GO, FOLKS. Prepare final questions and statments. We will share emails AFTER the doctors have signed off at the end. Thanks. (sysop) |
| Woodwomnz | I originally was given prednizone and it was a terrible experience ......... if I could find something natural I would prefer it |
| drburkhart | kv: any lesion that is chronic and long term can progress into something more serious. That is why it is som important to monitor and biopsy (periodically) any lesion. If any changes occur. Photographs and frequent checks are crucial. |
| moni | THANKS DR S |
| DrRees | don- sodium lauryl sulfate is an irritant but there are no reports of it causing LP. In the mouth it is washed away very quickly by saliva and generally it is not a problem. However, we usually recommend a bland toothpaste such as |
| kv | How often do you suggest checkups |
| don | Jan I had both concurrently! |
| ang | jp, i was on synthroid even before surg so I dont think there is a connection with the meds but maybe the stress and the lack of controls that the missing thyroid had on the body after surg |
| DrRees | don-Sorry, I hit the wrong key. Biotene. It doesn't contain SLS so we eliminate that as a precaution. |
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| Jan | So, how often should we rebiopsy? I do wonder if the LP could be masking oral cancer |
| DrSiegel | I have never felt that lichen planus is related to cancer. If you ask a dermatologist if LP is premalignant, they will say no. Why should the mouth be different. I have always felt that the LP might be masking an underlying tumor which has nothing to do with the LP per se. So, I always place the patient on steroid and see them two weeks later. If one area will not respond, I biopsy this site. I have found six cancers this way. ALL OF THE PATIENTS WERE EITHER SM |
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| fb | Biotene also makes a mouthwash that is the mildest I've found. |
| drburkhart | KV, you should go in any time that you feel a change has occurred or one that can not be calmed with whatever you are using. The patients at the stomatology center are generally evaluated every two weeks initially and then after they are under control, they are placed on periodic recall. |
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| DrSiegel | fb we finally agree...on the Biotene |
| DrSiegel | I should also add that it never hurts to get another opinion. If you are seeing a general dentist, seek an opinion from a periodontist, oral surgeon, oral pathologist, oral medicine person or a dermatologist who has experioence with this condition |
| dot | Thank you Drs |
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| ang | I am going for a biopsy at U of L dental school tomorrow what should I expect? |
| DrRees | Jan- The frequency of biopsies depends on how each individual is responding to treatment. If you have severe lesions I would want to re-biopsy yearly. Usually, however, that is not necessary. |
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| kv | I initially was seeing an oral pathologist every 2 weeks, then over a 2-year time have gotten it down to once a year. Everything seems to be under control. Do you think this is often enough if there are no changes? |
| irish | Type HEREI may have a natural treatment for you tht might help you, it has helped me |
| DrSiegel | Easy..they will numb you up like you were having a tooth filled and then the worst is aleady over with. A quick tissue sampling and often you don't even need a suture |
| Jan | I tell myself that since I do have good periods, I shouldn't worry about oral cancer at this time |
| Woodwomnz | IRISH ........... I'm interested in hearing it |
| jp | Do you agree with jan |
| DrSiegel | Jan...don't worry about cancer. Just keep being checked up every 3-6 months and biopsy any lesion which won't go away |
| JoeUK | ang - when they did my biopsy, they took a minute sliver of skin from the affected area on my tongue. felt like they were using a scalpel though i couldn't be sure. then they stitched it up and sent me off. unfortunately the first time it didn't heal up properly and i had to go back for restitching (apparently a very rare occurence). in total the healing took about a week - normally it should take 3-4 days. (one benefit of that snag was i was seen by a much more seni |
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| don | Incidentally, Radiation of the mouth /neck did not eliminate olp for me. |
| DrRees | ang-It is not usually necessary to take large biopsy samples so usually it is relatively easy. Most patients don't use pain medications afterwards but we usually prescribe them just in case. At any rate, don't worry about the biopsy, it is a lot less uncomfortable than the disease. |
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| dot | Iunderstand that they had found a cure in Gernany and theRx came from Japan, is this true? |
| DrSiegel | Don...Why were you radiated??? |
| ang | Do they biopsy every patch or just a couple? |
| irish | what is your e-mail and i will let you know what has helped me after 3 years of hell with steroid treatments |
| DrRees | dot-no |
| drburkhart | Jan, I am sorry, I missed your question. Are you worried about the vaginal and ca? If you need some literature on the subject, I could send you some. Contact me. Dore Eisen has written some good articles on the subject. |
| moni | When my oral surgeon did a biopsy I had 6 stitches is this normal? |
| Woodwomnz | IRISH ............ woodwomnz@aol.com |
| don | Oral cancer spread to my lymph nodes in neck! |
| DrSiegel | Don: I just wanted to make the point that radioation is not usually used to treat lichen planus. |
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| DrRees | ang- usually you pick one site but if there are multiple lesions it may be necessary to take more. |
| ruth | moni-I had 6 stitches too. The biopsied area was about 3/4 inch long in the middle of my tongue!! |
| moni | My question was to any of the DRS. |
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| ang | okay you guys with the 6 stitches are scaring me. Ha |
| DrSiegel | If there are multiple lesions, you surgeon might use a vital stain such as toluidine blue or use the new brush biopsy technique to sample a few of the other sites to ensure against premalignant changes.\ |
| dyuill | Am I ever glad they only biopsy'd my cheek! |
| JoeUK | hey ang - i'm *glad* i had my biopsy done - go for it!!! |
| aupton | ABOUT 5 MINUTES TO GO, EVERYONE. |
| DrRees | moni- Sure there are times when one needs to take 6 stiches. usually not, however. |
| DrSiegel | Moni: the sutures were used to close the lesion. If a large biopsy was taken, six sutures are not unreasonable. |
| Jan | They only biopsied my cheek also, not the sores on my gums or tongue |
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| fb | The biopsy isn't nearly as bad as having your teeth cleaned. |
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| ang | thanks for the reassurance |
| DrRees | fb-Thank you for that comment! |
| DrSiegel | Is this the San Fran Carp |
| Jan | The biopsy is the least of our worries |
| drburkhart | We hope to have these discussions every two months-I think that we are on a schedule now. Please contact us with any questions or follow up. |
| dot | Does deep gum cleaning cause more harm than good? |
| ruth | ang-it really is important. do it! |
| aupton | For the doctors emails, come to the web site www.tambcd.edu/lichen and drop us a note. |
| moni | THANKS TO ALL THE DOCTORS |
| Carp | Yes, this is the San Fran Carp |
| drburkhart | Carp-Hello Bill, glad you made it. |
| Jan | many thanks |
| dyuill | Thank-you all! |
| DrSiegel | Deep gum cleaning will minimize secondary bacterial infection of open lesions |
| Lou | Thanks to all. |
| DrSiegel | Carp How are you |
| aupton | Thanks to everyone. The room will stay open for about ten minutes for email sharing. Say g'nite, gracie! |
| DrRees | dot- It is essential to have your gums cleaned. it may make the LP flare for a few days but it is much worse to have plaque and tarter on your teeth. |
| Carp | Fine Michael and you? |
| ang | thanks to all for the great info |
| DrSiegel | good night and thanks for coming |
| irish | JoeUK: What are the typical treatments used in the UK |
| Dev | Thank you all especially Dr Rees ANd Dr Burkhart and DR Seigel |
| fb | bye y'all..thanks |
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| aupton | The transcripts for this session should be online on the website sometime tommorrow. |
| Jan | Thanks to you also Dev. your questions helped us |
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| Dev | Jan its always a pleasure are a doc? |
| DrRees | Goodnight all. Thank you for some excellent questions. i hope this has anwsered most of them. |
| drburkhart | Everyone, Dr. Carpenter (Carp) is at the Univ. of the Pacific and we have sent some patients who have lp to that facility. We appreciate your help. |
| Dev | jan are u a doc? |
| Jan | No, a LP sufferer |
| drburkhart | Thanks everyone, see you next time. |
| aupton | START SIGNING OFF PLEASE, FOLKS. |
| JoeUK | irish - i'm not qualified to answer that... i was recently given the all-clear from suspected olp (suspected by my general dentist) when i was biopsied. when i emailed dr burkhart to tell her this, she asked me to attend this chat anyway in order to pass on my experience of that process... |
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| DrSiegel | Carp: Sharon got her tenure yesterday!!! Hi to Bea |
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| Dev | well play it cool its a relatively common disease it ll go away! God Bless |
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| irish | Do you use any natural treatments at present |
| Carp | Michael, congratulation to Sharon. I knew that there was no question! |
| DrSiegel | Carp: Sharon got her tenure yesterday. Hi to Bea |
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| DrSiegel | Will I see you in Chicago |
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| Carp | I will be in Chicago on Wednesday, March 7, 2001 for the AADR. |
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| JoeUK | irish - i've recently found out i don't actually have olp... as i say i was asked to attend this chat anyway! (i feel like a bit of a fraud here ... :) |
| DrSiegel | That is the day I leave. Not going to Francina's palnning meeting??? |
| Dev | Dr seigel can be in touch with u ? |
| Dev | colud u send me ur e mail through Dr Burkhart? |
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| DrSiegel | Yes: I am at the University of MD. Dental School in Baltimore |
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| Dev | bye |
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| aupton | Room is closing, folks. See you next time. Please sign off now. |