Log file 12099 for
Chat room Dental_Study_Club
-- Log on 12099 started at Wed Jan 20 14:02:45 PST 1999
Lynn Can you advise me on amalgam
fillings and oral lichen planus. I get quite severe outbreaks and none
of the consultants I have seen have mentioned any possible link to
fillings.
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Burkhart Lynn, there have been some
published articles on your questions that I would be happy to send you.
There have been some reported cases of patients who have responded to
the removal of the restorations.
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Burkhart Lynn, In addition, the
information has not been evident or strong enough to encourage dentists
to start removing restorations-some patients do not respond
dianne Hi Doctor, So gald to find
this. I have have LP for 20 years and not found anybody to discuss this
with other than my doctors who don;t know too much about it. What is
the latest on any new treatments ? I am from Ontario Canada, I have
already done the prendisone and other drugs with no real help.
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Burkhart Jean, Welcome , and how can we help you?
Jean Hi. I have read all your session transcripts. Very interesting.
aupton Jean, Kathy and Babs. Welcome. The doctors will get to your questions as soon as they can.
Babs I have Lichen Planus and just looking for information.ype HERE
Burkhart Jean , how long have you had LP?
Jean But from what I've read, my condition must not be as serious as others.
Babs about 2 1/2 years
Jean It was diagnosed last July.
Babs Diagnosed by an oral surgeon from a ulcer on my tongue.
Burkhart Jean, Yes this is
true-there are six types of lichen planus and some are more severe than
others. The highly erosive type is the most painful for most patients.
Jean Mine is not painful, just worrisome.
wright Type HEREDiane he main
treatment is still various types of steroids. The newer generation
topical steroids have been very useful in controlling symptoms but they
do not cure the LP. Patients respond differently to different steroid
preparations so you may need to experiment to find the best treatment
regimen for you. An oral pathologist or dermatologist would be good to
cnsult with. Wright
Jean I have it on the inside of my cheek, and on my tongue.
Kathy I don't really have a
question. Just wanted to comment after being on Prednisone for 9
months, developed Cushing Syndrome. Got off Prednisone by September.
Had a really bad time until I started Plaquenil on 11/11. Have had
great results since then.
Babs same here
dianne Dr Wright, What other steroids beside dermovate could i ask my doctor about ??
Burkhart My original message was
not completely entered. I would like to take the opportunity to
introduce Dr. John Wright to you. He is an oral pathologist and
professor of oral pathology here at Baylor. At about 4:30, we will be
joined by Dr. Jeff Rossman, a periodontist and professor here also.
Jean I just found out my brother
had it a couple years ago. He said he used Mary's Magic Potion and it
went away. Ever heard of it?
Lynn The only treatment I have been
offered so far is steroids which seemed to aggrivate the symptoms. Like
Dianne, I'm looking for hope as well as help I guess
Babs I have used that and it hasn't helped me much
wright Diane We have had great luck
with Lidex (fluocinonide gel). In addition to temovate, diprolene works
well in many patients but these latter two promote yeast growth more
than the Lidex. Systemic treatment works extremely well but there are
side effects from long term use and we try to control the flare ups
with topical meds if we can. Wright
Jean Is that the real name for it? What is it?
Burkhart Jean, I have not heard of this-but, sometimes the rinses are called different names.
Jean Oral surgeon gave me
Triamcinolone Acetonide, but it didn't do anything. I used it for about
3 weeks, but I don't use anything anymore.
Burkhart Jean, have any of your other family members ever had LP? Was your brother's LP related to a medication?
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Kathy I have heard of Mary's Magic
Potion. My doctor started me out on that also, but it didn't help. It
is a combination of several things, but I don't know what any of them
are.
Jean I don't know. I just found out
today that he had it. I need to talk to him further. He said sometimes
it comes back, but not as bad as the first time.
dianne Has there been any relation found to certain foods ?
wright Lynn One of the most common
reasons for steroids not to work is that they encourage yeast growth.
It is common for the steroid to help with the LP but the secondary
yeast infection produces symptoms and patients then think the steroid
is not working. Is your doctor seeing you after the steroid doesn't
seem to work? Wright
Jean Is this Mary's Magic Potion prescription?
Burkhart Kathy, where do you live-in what region?
Kathy Yes.
Kathy I live in Indiana.
Jean I live in Indiana also.
Kathy What part?
dianne would eating alot of yogurt work against the yeast in the mouth ?
Jean Fort Wayne
Babs I live in Alabama
wright Diane In general th
Kathy I'm just south of Indianapolis.
Burkhart Have any of you ever been able to link the LP to any foods or life-style factors?
Kathy Garlic really seems to set mine off.
wright Diane In general, LP is not
considered to be a food allergy. Foods commonly aggrivate symptoms but
are not causing the problem. Wright
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Jean I am a smoker. Does smoking make this condition worse?
Jean You said there are six types of LP. Does that mean mine can get worse, as far as soreness?
Burkhart Kathy, I have received
email from some patients who report conditions to be worse when eating
acidic foods, apples and while using some toothpaste products.
wright Jean Interestingly, most of
my LP patients are nonsmokers. Smoke, like many foods, can aggrivate
the symptoms but it isn't causing the problem. Wright
Kathy Jean, I am a smoker also. I
know smoking increases the chances of the LP turning into cancer, but
the stress I have experienced when I've tried to quit, made the LP
worse.
Jean Do you think if I quit smoking (I'm trying) that it might clear up?
dianne From the beginning I noticed
banana aggravated my mouth and later fresh fruit, tomatoes and pears
did the same and i've just recently gone to an allergy specilist trying
to find help for my LP, when he tested me he says I have what is called
- ORAL ALLERGY SYNDROME. Because I am allergic to trees, I am also
allergic to fresh fruits that are pollunated by these trees . So in
effect I have 2 problems assoc with my mouth and was wondering if any
of you have found this als
Babs no, I use to smoke when I had it and I quit about 2 years ago and still have it.
Kathy I don't have any allergies.
Burkhart Jean, How does your
condition appear at present? Where is it located? Sometimes we may need
to ask you to repeat responses because we can only view the portion
which appears on our screen.
wright Jean Smoking cessation should help with your symptoms but I don't think it will cure your LP. Wright
Jean does everyone on here have
painful LP? Mine is not painful, I just get a slight soreness on my
tongue sometimes, but I think that could be from smoking.
Kathy As much as I hate to admit
it, when my oral pathologist suggested I take 10mg Valium at night I
resisted. When I finally gave in, I did find my LP got better. I took
it through the holidays, and now just MAYBE once a week.
dianne Jean - at times VERY ! prevents me from talking at times.
Jean I have it on one side inside
my cheek. Started out about the size of a dime, and it feels like it
has covered almost half of the cheek.
wright Everyone There are numerous
drugs on the market that will "cause" or at least aggrivate your LP. If
your Lp is drug related, switching to another drug may cure your LP.
Talk with your doctor about the meds which do this and check to see if
you are on one of the offending drugs. Wright
Kathy Mine used to be that bad, but
as I said, the Plaquenil has really helped. I've not had any lesions
since I've been on it.
Babs The first time I had it about
2 years ago, it didn't bother me but I have had a problem since about
Thanksgiving and it has been all under mu tongue on both sides and the
inside of my cheeks and on the back of my throat and it has been very
painfu.
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Jean Also on my tongue. Area about the size of a quarter towards the back, and small white spots towards the front.
dianne Babs , here is my email - diannedoucette@hotmail.com - drop me a note sometime and we can swap
Kathy Dianne, are you by any chance a court reporter?
Jean Can I expect mine to get worse, as far as getting painful?
dianne No. I live in Ontario Canada. My husband was a cop. Do you know someone same name. ?
Burkhart Jean, In answer to your
question about will it become worse, we really cannot predict this.
Some patients go into remission and the lp does not come back. Some
patients, however, have an ongoing problem. Keeping a diary sometimes
helps you become aware of the trigger mechanisms.
Kathy Yes -- I think -- maybe it's just similar.
Jean I have read all your session
transcripts and have tried to avoid foods they talked about. Have also
been using Biotene toothpaste and mouthwash since reading about it.
Kathy I also just got a Sonic-Care toothbrush and it is great -- expensive but well worth it.
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Burkhart Jean, have you noticed any difference since you started using these products?
dianne Dr Wright, I have been told
by my Doctor that it has not been documented but I feel I have this
disease in other parts of my body such as throat, esphogus, and ears?
etc. anybody else ever experience this ?
Jean I don't know that anything triggers it, because mine doesn't seem to change. Like I said, I have no pain or soreness.
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Babs Yes, I have some on the back of my throat now. Painful
Jean No, I haven't noticed any difference from the Biotene, but I keep using it.
Jean What does LP on other parts of the body look like?
aupton Folks, Dr. Wright had to leave a bit early, but Dr. Rossmann has now joined us.
Kathy Dianne, no. Mine has only
been in my mouth, mainly my tongue. My tongue always has the white
patches, but they never turn raw. Still fighting gingivitis -- seems to
be a constant battle.
Burkhart Dianne, Dr. Wright had to
leave. Yes, I have spoken to some ENT people who have cases that they
treat on a regular basis. Also, some pathologist are suggesting that
women who have oral lesions should also be evaluated for vaginal LP.
especially if they have any symptoms to suggest this fact.
Kathy I should say my tongue has not been raw since starting the Plaquenil.
Babs My e-mail address is
Babs3444@aol.com in the evening and would love for anyone to e-mail me.
It is good to know you aren't alone.
Jean Do medical doctors know anything about LP? Mine did not know what it was when I first went to him for my mouth.
dianne Dr Burkhart, Yes I have been
diagnosed with vaginal LP and wonder now if i have rectal Lp also. IS
that very common or more rare.
Jean Kathy, what is Plaquenil?
Jean Does anyone know if that Mary's Magic Potion is prescription?
Kathy It's acutally a drug that was
for malaria and arthritis, but they have found out for some reason it
helps LP. You have to have regular blood tests and eye exams while on
it.
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Babs Yes, except my prescription called it Magic mouthwash.
Kathy Jean, yes, Mary's Magic potion is a prescription. It did not help my LP at all.
Babs I guess this is the same thing.
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Burkhart Jean, lichen planus has a
purple-brown colour and may appear on the legs or arms. The lesions
that are in the throat and vaginal areas will appear similar to the
oral lesions.
Jean Did anyone else have their LP start out as no soreness or pain? And then it got worse?
Babs yes ne
Jean When it's on the legs or arms, are they sores, or rashes or what?
dianne Jean, LP on my tongue drain
and the fluid has the colour of an infection (green yellow) when i
rinse my mouth i can see this clearly or watch this drain. I have the
same fluid comes from my ears, which does not respond to anit-biotics.
Also i have a buildup of tissue on my eardrum which the Dr is baffled
by and he is an ear specilaist. This seems to me to be the erosive
buildup part of the disease. !!!
Babs The first sore I had on my tongue was just one place and it didn't hurt at all.
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Burkhart Diannne, most of the cases
that are reported tend to be vaginal, but with any mucosal tissue, you
may possibly have it rectally. The best thing to do is to bring this to
your doctor's attention.
Jean Babs, now yours is very painful?
Rossmann {Dianne} The gingivitis
problem spoken about may be another version of lichen planus, known as
the erosive type. It is found in the gingival tissues and can mimic
gingivitis. It is best if yoiu have this evaluated by a periodontist.
dianne I think every form of it, my body has displayed it. I've had it 20 years
Jean How long has everyone had it?
Babs Yes, I have a mouthful on the
bottom side of my tongue, the side of my mouth and my throat. Can't get
rid of it. It gets better and then worse. Never seems to heal since
before Christmas.
Babs 2 1/2 years
Kathy I have the erosive oral LP,
have my teeth cleaned every 3 months. Going to change and have my
dentist clean 2 times a year and a periodontist clean 2 times a year.
Kathy I was diagnosed 20 years ago, but never had any problem until about 2 years ago.
Burkhart Jean, just to follow-up on
your question. No, you may never get the erosive form. The important
thing to remember is to have the lesion evaluated at your exams and
call any ulceration to the attention of the practitioner.
Burkhart Kathy, yes the research supports that meticulous home care helps in keeping erosive LP under control.
dianne Dr, my dentist recommended
not touching it - not cleaning it. he didn;t want to tocuh it, disturb
it, scratch it. it was so bad he figured he didn;t want to make it
worse. Would it make it worse ???.
Rossmann Kathy, we have had
excellent success in supplementing the quarterly cleanings by your
dentist with use of a chlorhexidine mouthrinse when the lesions have
flared. The commercial name for this product is Peridex and is by
prescription only.
Jean Is there one type of doctor who may be able to care for this over another kind? I have been seeing an oral surgeon.
Kathy Is that the same as Perio-Guard?
Babs My teeth seem to keep my
tongue ulcerated. My ENT told me to ask my dentist to file a tooth that
seemed sharp to him down. The denist did and it went away for a long
time.
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Burkhart Jean, the best treatment
will be with someone who is well-versed on lichen planus-no matter what
the specialty. Some individuals have an interest in mucosal disorders
and may be very good at what they do.
Rossmann Dianne, when the lp is
active I recommend application of a Lidex gel. This is a toipical
steroid, by prescription and has been very helpful for the syptoms of
lp. In addition , I would begin using the mouthrinse mentioned above.
Jean Kathy, what was it like for
the first 18 years? Were there areas that kept getting bigger. That
seems to be what mine is doing.
Jean Dr. Burkhart, how can I find someone who is well-versed on this?
Lynn I've got exactly the same as
Babs - has anyone any methods of calming an outbreak down before it
really gets going. Under my tongue and the roof of my mouth are about
to go balistic - anything to avoid or to try ?
Burkhart Have any of you noticed a relationship with stress?
Babs yes, I run a one person office and always something
Rossmann Kathy, both Perio-Gard and Peridex are the same product.
Jean I don't notice mine associated with anything. Mine's really not bothersome. I'm just concerned.
Burkhart Since we began the web
site a year ago, we have made many contacts throughout the world with
practioners who have an interest in lp. If you contact me directly
through my email, I will put you in touch with someone in your area.
Kathy I use Biotene toothpaste, a
proxy (sp?) brush, tongue scraper, floss, rinse with the Perio-Guard,
then brush with Prevident.
Jean Ok. Thanks. How do I write you?
Kathy Jean, for the first 18 years
the only thing I noticed was that spicy things seemed to burn, but
never had any lesions or rawness.
Burkhart Jean, just go to the site and click on my name in blue.
Jean OK.
Rossmann Kathy, you seem to have a
good regimen for the lp, since bacterial plaque will aggravate the lp.
The better you remove the plaque, the less it will effect the lesions.
dianne Thanks for this great
service..I'll be back to visit. Also Dr.Burkhart - Yes to the
relationship with STRESS...also at extremly happy times (birth of
grandchild) for a few moments while i had been experiencing alot of
pain, for a few moments i had a great relief from the pain. THANKS
EVERYONE BYE FROM CANADA.
Burkhart Do any of you have a regular exercise routine such as walking, running, yoga or anything for stress reduction?
Jean Is Prevident a toothpaste? My daughter had that as a rinse with her braces.
Babs I take spells with my exercise. Not much lately.
Jean No exercise. But I should.
Kathy I'm trying. Just don't seem
to have enough hours in the day to take care of teeth, exercise, work
my own business, and try to keep a house in some sort of order!
Rossmann Jean, Prevident is a
topical flouride paste. It is applied as a toothpaste, but should not
be used long term as a dentifrice.
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Jean Most of the medication I've
read about in your transcripts are prescription. How can you try one
kind.....ask your doctor to try the various kinds?
Lynn Kathy, I'm in the same boat as you regards time. ?
Kathy Just found out this summer my
cousin's daughter was biopsied with LP - a small bald spot on her head.
That was about 10 years ago and has never had any other symptoms.
Anything about it being genetic?
Burkhart Kathy, I just found a
great way to walk at my local health club on a treadmill while
listening to the national news wearing headphones. I realized that I
was sitting in front of the television and I could be walking! It has
worked for me and I highly recommend walking.
Babs Got to leave now, going home
from work. It you are still on when I get home, I will be back, if not,
thank you all for the good information and possible help.
aupton We have about 5 minutes to go, folks.
Kathy I got a treadmill from Santa
and have been faithful so far. I'm trying to do 30 minutes, 2 times a
day, but don't always get that second one in.
Lynn My mother in law and brother
in law both have lp. My daughter who is 5 have very frequent and
painful ulcers - I can't bear the thought that she also has this - is
it possible in a 5 year ol?
Jean It is not contagious, right?
Burkhart Jean, there is no indication that in all the reported cases thus far, that LP is contagious.
Rossmann Jean, my recommendation is
to try one medication at a time for the lp and only swtich if it
becomes ineffective. As with any disease of multiple origins, the
single anwer is not found with one medication for everyone. There are
increasing strengths of these medications and they should always be
given as the smallest dose that is efective to handle the symptoms.
aupton Folks, all good things must
come to an end. It is time for the doctors to ride off into the
'webset.' Please tie up loose ends, and we'll see you next month!
Kathy Thanks for being there for us!
Burkhart Lynn, please complete our
survey-we are especially interested in family patterns. You daughter
may have something completely different.
Jean Thanks for your help.
aupton Thank you all for joining us. If you'd like to be on our mailing list, drop me a note at art@tambcd.edu
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-- Log stopped at Wed Jan 20 15:05:04 PST 1999
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