Log file 022499.html for
Chat room Dental_Study_Club
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aupton Hi, babs, we're just getting started
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Babs Good afternoon
Burkhart Hello Babs, welcome to the discussion group. How can we help you today?
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Burkhart Hello Dianne, How are you?
Babs I have Oral LP always looking at new studies and information
Burkhart Babs, how long have you had OLP? What type do you have?
Dianne Fine Dr Burkhart...thanks...Glad you are all here doing this.
Babs A little over 2 years. Don't know what type. It was diagnosed by my dentist.
Gage Did you have a biopsy done to confirm the diagnosis?
Burkhart Babs, do you have any discomfort? Are you taking any medications?
Babs Yes. It is better now but I have had a lot of discomfort in the past months.
Gage Babs. What are you using now to treat your LP?
Babs It has been flared up since last November. I have tried several things . Hold on let me get the ointment.
Babs Fluocinonide Ointment. It has worked pretty good.
Gage Babs Please confirm that you are using an ointment rather than a gel.
Burkhart Dianne, What symptoms do you have or are you having any problems?
Babs yes an ointment
Babs I seems to have reduced the sore bumps on the sides of my tongue.
Dianne yes I have a terrible time with my mouth which is ongoing and also vaginal etc.
Gage Babs. In our hands the gel has given somewhat better results than the gel. However, the drug you are using is the first choice for us for OLP patients. I might suggest that you swith to the gel formulation of the same drug. There are other topical steroids that can be used if you are do not respond to the gel.
Gage Babs. Excuse me. I should say the gel has given better results than the ointment.
Dianne I have been diagnosed by biopsy 20yrs. mouth 20yrs vagina about 10yrs
Babs My dentist said if that didn't work to let him know that he had something else to try. Do I have to get a prescription for the gel ?
Burkhart Dianne, is you doctor aware of the vaginal lesions? We have been hearing this from some women lately and it certainly has been reported in the literature frequently. Oftentimes, the connection is not made unless the patient reports the vaginal lesions to the dentist.
Gage Babs. Yes, these king of steroid products require a prescription. You dentist can write for the gel formulation .,
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Babs I will get him to give that to me. I got him to file down the sharp places on my teeth down. It seemed like that was where the ulcers were on my tongue.
Babs I try not wo sleep on my side. It also makes sores on the inside of my cheeks.
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Burkhart Dianne, have you been able to document anything that you come in contact with such as food, any environmental factors that make the lichen planus worse?
Rees Dianne, I am with the Baylor group also so don't take this personally but we very interested in what methods are being used to treat vaginal lesions are being treated. Can you tell us about that?
Gage Babs. You dentist could also make a soft, plastic guard that could fit over your teeth and that would feel smooth to your tongue. This would help reduce the irritation of your tongue.
Dianne I the beginning when I first started to have problems in the the vagina I was afraid that it was lp but my gyn said no . we spent about 3 yrs treating with avc cream etc. finally i went another city and had a biopsy and confirmred lp. at this time my mouth was a mess and i went on mega steroids. no real help and here i am with everyone else.
Babs I thought about that. I may ask him about that. He is very interested in helping me out. He wants to know when things work for me.
Rees Dianne, are you taking any medcications other than those for the LP?
Burkhart Dianne, what are you currently using for the oral lp? What have you used in the past?
Babs ISs there any certain amount of time that these flare ups last?
Babs Gage, why did you say the gel was better than the ointment:
Gage Babs. In our hands, the gel seems to give better results than the ointment. In may be that it is easier to apply, but it could also relate the lenght of time the gel is in contact with the OLP lesions.
Rees Babs, no they can be quite varied in length. The best thing to do is to increase the number of topical applications when your mouth first starts burning or feeling raw. Often you can avoid the outbreak this way.
Dianne rees i would be glad to talk to you further my e-mail is diannedoucette@hotmail.com . please contact me with your questions ok
Dianne burkhart i have used many drugs in the past but now only dermate sparingly and just started chlorehexdine
Burkhart For anyone reading our transcripts: We have a survey on the page and would like to call this to your attention. The survey will give us some good information on the demographics of our participants, health histories and some possible commonalities that we may want to pursue in research areas.
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Rees We seem to have reached a lull in the discussion. I'll take advantage of that to note that sometimes the triggering factor for lp can be identified. In those cases eliminatiog those triggers can resolve the lesions.
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Burkhart Dianne, How intense are you lesions? Do they just last a short time?
Gage Rees. Yes I believe that nonsteroidal antiinflammatory drugs and diuretics have been linked to LP or LP like reactions.
Dianne the triggers i have do not clear flare ups but i do avoid making it worse i think
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Babs Are we back.
Rees Dianne, do you know what those triggers are?
aupton Babs, you're back on, yes.
Burkhart Dianne, do you remember anything about you very first lesions that you had in your mouth? Was anything going on in your life at the time-stress related?
Dianne burkhart my mouth is very bad both sides of tongue and inside both cheeks and also the gums. i have a lot of scar tissue on my tongue
Babs What is your feeling about this being pre-cancerous?
Rees Dianne, your lesions sound bad. Do they come and go or are they constant? I am especailly interested in those on your tongue. Is it the sides or top?
Babs I have a lot of stress with my job. I think maybe that is what have triggered my problem. Big stress on both times I have had flare ups.
Burkhart Babs, we usually tell all patients that any chronic erosive(ulcer-like) lesions anywhere in the body should be monitored and any changes should be evaluated.
Dianne rees i find my triggers are fruits and vegies especially fresh and raw spicy foods sugar some choclate chips hard food like toast even a food like kraft dinner or home maade bread but i thik the last 2 only because of the part of the tongue i use to chew and etc etc.
Gage dianne Do you use diet beverages with artificial sweetners.
Rees Dianne, the raw spicy foods, hard foods and fruits are easy to understand because they can cause the tissue to peel away. It is a little harder to explain why vegetables would cause aproblem
Dianne burkhart i do remember my first lesion very well. i believe it came after i accidently bit the side of my tongue you know haow you do sometimes as a reflex. about the same time my folic acid was low and i needed a prescription to bring it back up . the lesion cleared but did return and return and it seems eventually to stay.
Rees I think we need information from both Babs and Dianne regarding the type of toothpaste you use.
Burkhart Babs, have you ever tried any type of stress management? What do you do to release tension or stress? Do you do any type of exercise?
Rees Also do you chew gum or use a mouth rinse?
Babs Some exercise, not enough. Play games on the computer.
Dianne gage i stay away from artifical sweeteners and color as i also find them to be triggers thank yourees f
Babs I sometimes chew trident gum. Not when my mouth is flared up.
Gage dianne. thank you. sometimes people with OLP may have other problems in their mouth as well and one of thise is allergic reactions to tartar control toothpastes, cinnamon contining foods or spicey foods. Have you ever been evaluated for allergies?
Rees Babs, what flavor of trident do you usually chew?
Babs I regular
Burkhart Dianne, do you take any type of vitamins?
Dianne rees i also have oral alergy syndrome which will explain the fruits and vegies as they burn . so in effect i have 2 problems in my mouthl
Babs I went for two years with no problem at all. It didn't matter what I would eat.
Rees Dianne, just as a thought you may have a third problem as well since topical steroids may make you susceptible to yeast infections in both the mouth and vagina.
Burkhart Babs, can you remember any changes in you life-style during that period of time?
Dianne rees i used crest until last month when i stared baking soda. it seemed ok for awhile but now burns also. i have just ordered some biotene from my drugist and will give that a try . my dentist reccomended only brushing no paste or soda at all but i feel i must give them a try
Dianne burkhart i take a multi vit b with carotene
Babs Yes, we had a big move at my office the first time with some problems that were over whelming to me and the latest one was a lot of problems testing for y2k. That is still on going. Try not to bring that home with me.
Burkhart Dianne, have you had a recent exam with blood studies? Has your folic acid problem every occurred again?
Rees Dianne, I am glad you have switched from Crest but we find baking soda to be irritating as well and brushing without paste can peel the gums too. Biotene is not the only bland toothpaste but it is a good one to try. the rule is, if it burns, don't use it.
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Dianne rees my gp says i don't have yeast. i have never been bothered by any yeast infestions but i do try to eat a lot of yogurt with live cultures this may help
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Rees Dianne, just for the record, yeast infections do not always look the same as we expect when one used topical steroids or some other topical or systemic meeications
Dianne burkhart it has not returned. i just think that because my blood was low at the time i was more succeptable ?
Dianne Rees oh interesting i will keep that in mind
Burkhart Babs and Dianne, Do either of you have any family members who may have had lichen planus either in the mouth, skin or vaginal?
Babs No
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Dianne burkhart no
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Babs I have had different types of rashes in the past.
Dianne rees how would i know if i have yeast in the mouth?
Babs I once had erythema multiforme.
Burkhart Babs and Dianne, do you periodic photographs taken when you are examined?
Rees Dianne, it often looks and feels like LP except you don't develop ulcers. The tissue may be red and sore and burn just like LP. We often prescribe an antiyeast medication (topical) when we start using topical steroids.
Babs no
Rees Babs, your comment about erythema multiforme is interesting since it may represent an allergic reaction as is true with LP. Do you remember any meds you were taking when you developed LP?
Dianne burkhart 20 yrs ago photo of my mouth were sent to some place in texas by my oral surgeon, queens university in kingston on. ca. has the rights to my bottom picturs ugh.
Rees Babs, I meant when you developed EM
Babs No, I think I decided it was bad pork. I was pregnant at the time
Dianne rees what medication should i mention to my gp
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Rees Dianne, when you get the transcipt of our session review what Dr Gage mentioned, drugs used to treat arthritis, hign blood pressure, heart disease or diabetes seem to be the most common but in therory any drug can cause a "lichenoid" reaction which won't go away until the drugs are discontinued.
Babs Aftrer I had EM, my skin was real sensitive. If I was scratched by an animal, I got itchy bumps on the place I was scratched.
Dianne rees the only drug i am on is synthroid fir hypothyrodism
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Rees Babs. has a dermatologist evaluated you regarding these skin reactions? They also know a lot about LP
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Babs No, I never had a real big problem with it and never had it evaluated.
Burkhart We suggest that periodic photographs be made for case documentation. It is difficult to detect changes in tissue that is highly erosive if subtle changes have occurred.
Rees Dianne, as far as we know synthroid doesn't cause LP
aupton It's time to sign off folks. Thanks for your participation.
aupton Transcript will be posted by tommorrow on the Web site.
Babs Who do I see about making photos of this. No one has ever asked too.
Dianne bye everyone hope to talk to you soon
aupton Thanks, Dianne.
Babs Hope to catch you next month.
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Burkhart Thank you for your participation this afternoon. If you have any follow-up questions are comments, please email us and let us hear from you.
Babs Thank you for your time
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-- Log stopped at Wed Feb 24 15:07:02 PST 1999
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