Transcript 050915 for #Dental_Study_Club

Log file 050915 for
Chat room #Dental_Study_Club

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aupton	Hello, jc11 and mm the docs will be here shortly.
JC11	thanks
MM	thx
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aupton	hi, everyone. dr burkhart will start the session in just a moment
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aupton	hi patty, the session will begin in a moment
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Pattyf	Thanks
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aupton	hi, doctors. We're waiting or dr burkhart to begin
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drburkhart	Hello everyone. Sorry I had trouble getting on myself!
aupton	ok let's begin
DiZel	Type hereI have just recovered from spinal osteomyelistiswhich stemmed form open lesions in my mouth from OLP.
JC11	What are the effects of sun on OLP?
JC11	lips mainly
JW	I use lidex gel in my mouth every night. Can this cause me to gain weight?
drburkhart	JC11-Do you have external lesions as well?
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Pattyf	What are some of the treatments that cause relief. I have unbearable pain off and on for 20 yers.
JC11	not really lesions, mainly redness
DrsBrennanandFox	JC11 We are unaware of any effects of sun on OLP. The sun can reactivate Herpetic lesions
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aupton	new visitors. The doctors will take your questions as they can -- please be patient
JC11	what about protopic in the sun?
drrees	Hi, eveyone. Patty we have mostly used topical steroids that seem to be very effective for most patients. What have you used over the 20 years?
drburkhart	JC11, I get emails from patients who have some problems with the sun and skin lesons, but it seems to depend upon whether the lesions are extensive and erosive in nature.
flower	Type here flower Hello Dr. B I have been ok for 2 yrs now my OLP is back,I,ve taken Nizoral
DiZel	Protopic doesn't help at all. Aything else? Something for the pain?
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drburkhart	Hi Flower! I do remember you. Do you know what may have been a trigger for your current out breaks?
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drrees	JC11- Protopic can probably cause some tendency to develop sunburn in the areas wwhere it is applied.
aupton	new visitors. The doctors will take your questions and answer as they can. Please be patient and no crosstalking, please.
flower	flower but I'm not getting results, any other options?
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DrsBrennanandFox	PattyF-Have other causes of your pain been ruled out? For example, fungal infections or vitamin deficiencies
drburkhart	Flower, is the LP on your scalp?
drrees	Our visiting doctors have a great deal of expertise regarding the possible relationship between dry mouth and OLP. I wonder how many of you who have olp also find your mouth to be dry?
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flower	Flower stress and too many antbiotics
JC11	If LP has surfaced but subsided in other place does that make OLP more likely to subside on the lips, or does it operate completely independent of other areas?
JW	I have used lidex gel in my mouth for two years and have gained 15 pounds. Never had a weight problem before. Can the lidex be causing it?
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Pattyf	Dr. Rees, I have mainly used Triamcinolone Acetonide recently with minimal relief.
drburkhart	Flower, why were taking the antibiotics and what type of stress-chronic related to everyday type things?
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aupton	Hi, new visitors. The doctors will take your questions as they can.
Mimi	Have OLP and VERY dry mouth. Do you consider chewing gum helpful (it does moisten the mouth) or not?
Judah	I would like to share an experience with BIOTENE, uh, fake saliva, I think it's called when there is time
Claude	I experience dry mouth, but particularly dry lips. What treatment can you recommend?
Judah	lol
drrees	Patty, you should talk to your doctor and make sure that it is olp that you have. If so, the triamcinolone may not be strong enough for you.
DrsBrennanandFox	We haven't heard of a connection between using Lidex gell and weight gain. Maybe you are more comfortable and can eat more!
aupton	Judah, please stay with the question/answer format. Thanks
drburkhart	Mimi what type of gum-one that is sugarless?
Coro	My OLP was diagnosed a year ago, but dry mouth is a recent thing and seems to get progressively worse. Is that usual?
JC11	biotene has worked very well for me, dry mouth has improved alot
Mimi	yes, sugarless. Not only my mouth is dry, but oftimes my throat too.
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drrees	Mimi, sugarless is probably of some benefit in stimulating your own natural saliva.
Pattyf	I have had my diagnosis confirmed, can you recommend stronger medication to discuss with my physician.
Mimi	thank you. it does help. :)
Tina	What test or biopsy should be taken in order to know exactly if you have lichen planus? I have had biopsy and they say it's like lickus planus.
JW	I also get breakouts on my ankles and lower legs but when I get this, my mouth clears up. Is that a common thing.
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drburkhart	Mimi, Biotene makes a gum that is one that many patients use.
aupton	discussion aid: type the name of the doctor to whom you are addressing your questions, or simply type "doctors" then the question
DrsBrennanandFox	Concerning dry mouth and lips, there are a number of approaches to treatment. You can try to moisturize the lips with a hydrating cream or ointment - like Aquaphor - or use a capsule of vitamin E, opened and spread on the lips. usually, vaseline will coat the lips but not help with dryness.
flower	DR B How long can i take Nizoral
Mimi	Yes, I've used it as well as a dry mouth lozenge, but regular sugarless gum seems to help more.
drrees	Patty, I don't think we should talk about specific recommendations in this format because we don't know enough about your situation. You could mention to your doctor however that there are some studies that suggest that stronger topical steroids may be more effective.
Tina	DR BIs there any more hope of a cure for lichus planus
Tessa8898	doctors? I am using Clobetasol Propionate Gel, 0.05% in my mouth for lesions. What do you think of this medication?
Pattyf	Dr. Rees, thank you, I will do so. Thanks for this opportunity to communicate!
DrsBrennanandFox	Concerning gums and candies to relieve dryness, be sure that anything you use is sugar-free. In terms of sugar substitutes, look for a product that contains xylitol. Xylitol will actually help prevent dental decay.
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j	doctors, any treatment for LP of the fingernails
Mimi	Doctors, my oral surgeon has strongly suggested laser surgery, but the discomfort he mentions helps me to refuse it.
Mimi	How do you feel about laser surgery??
drburkhart	Flower, you are using it because of a fungal - candida infection in your mouth? Or is this external? How long have you been using it?
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JC11	doctors, OLP is thought to take place during some kind of life change from what I hear, is this due to hormone levels or what?
ak	Type hereakok,connect
DrsBrennanandFox	Mimi- are you talking about laser surgery for lesion removal?
Eruta	Type hereDr.B What causes the mouth to be so dry during sleep that it gets you up inthe middle of the night?
Mimi	yes.... he would do one cheek at a time. He said he's done a lot. ??
drrees	In our clinic we have not had much success with laser removal because the lesions tend to occur in multiple sites.
DrsBrennanandFox	OLP outbreaks are likely related to stressful episodes.
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DrsBrennanandFox	We would not recommend laser removal of OLP lesions
Mimi	I agree. That's why I've refused. I also rinse often witth Biotene mouthwash.
flower	You are right i have a fungal infection in my moulth I have taken them 14 days 200 mg
drrees	JC11- We have looked at hormonal levels but have not been able to detect a correlation.
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Tina	Dr B My ? I had was what biopsy or test should be taken to know if it is definitely lichus planus. I have biopsys and they say it's like a lichus planus and they treat it as such. Is there anything else I can do to get another opionion.
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drburkhart	Erutal, if your mouth is already dry and you are a mouth breather, the dryness is increased. Have you tried one of the biotene products that promotes oral moisture before you go to bed? Also as Dr. B and Fox said, you can use Vit e or chapstick (black and white on the lips) for dryness.
ak	the lichen plantis inside my right lip is not healing this time. I use fluocinonide gel .05%
drrees	Someone asked about Nizoral. It is effective but you should be monitored for possible liver damage over time. We prefer topical agents such as nystatin oral suspension.
JC11	Dr. Rees, for mid-life women is it changes in the body, or probably the mental stress from the change in the body?
flower	Janice are you here to day miss your e mails and confort
DrsBrennanandFox	Tina- A biopsy is the most definitive test available. You could ask that the slide be looked at by an oral pathologist.
aupton	flower - no crosstalking, please
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JC11	or both
drrees	JC11- I don't know but we do know that aging can affect immune status in women a little more than men.
Tina	Dr B Again, is there any cure in site for lichus planus?
Mimi	I have also found warm salt water to help when I have a particularly sore mouth.
drburkhart	Tina, the usual biopsy is a tissue sample that is viewed under the microscope by an oral pathologist and at the same time another tissue sample is viewed using what is called immumofluorescent staining. If both confirm that it is OLP, you have certain diagnosis.
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RAG116	i use biotend toothpaste and mouth wash and it does not help the dry mouth
JC11	dr. reesI am a young man, apparently younger than most cases, I am trying to figure out if artificial increses in testosterone , or the drop off afterward may have triggered this.
DrsBrennanandFox	The cause of OLP is still not clear, so a cure is still some time away. However, it can be managed fairly well - in most cases.
flower	Aupton did you receive my email
drrees	RAG116. There really is not a foolproof material to treat dry mouth. We like biotene because it is mild.
ak	ak I have been biopsied twice and both results showed lichen plantis. It will go away for a while but the fluocinonide gel .05
drburkhart	Hi everyone, this screen is rolling really fast-this could be the most number of people we have had on line. So if you are not getting answers, it isn't that we are ignoring you, we just can't get to everyone fast enough.
RAG116	my olp is not going into remisson at all i have had it for about a year more sores are coming up all the time
Judah	my dentist recommended the biotene saliva substitue for my dry mouth, instead of the mouthwash which I was using. After a few weeks i was "cured" - my dry mouth during sleep has vanished, and not returned, even though I have stopped using the product
aupton	I am not monitoring emails during the session.
drrees	JC11- To my knowledge there is no known relationship to testosterone levels.
JC11	thank you
Mimi	The gum that works best for my dry mouth is Extra Winterfresh.
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pam	I was diagnosed with OLP over a year ago. This is what helped me. A great dentist (like Dr. Brennan, Temovate Gel, children's toothpast and extra soft toothbrush. And....stay away from hot, spicy foods.
DrsBrennanandFox	Biotene products are for relief of symptoms and to help prevent complications of dry mouth. They are not treatments, as such. There are drugs used to treat the underlying causes of some cases of dry mouth and others which will increase salivary function.
drburkhart	Mimi, that is interesting because wintergreen often produces problems as a flavoring agents in most patients.
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Tina	Dr B If you have the biopsy or the immumofluorescent staining done and your lichen planus is in remission, can you still tell whether or not it is really lichen planus?
Eruta	use biotine oral tooth paste and mouth wash and Biotine oral balance,to no avail. Best befor i go to bed I fill my mouth with my own saliva...helps somewhat..What is biotine saliva substitute????
Tessa8898	I had a bite guard made & it has helped me much more than the biotene or the chapstick,etc.It keeps the dry tissue from sticking together. I wear it all night & most of the day.
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drrees	Eruta- biotene is not a salive substitute
JC11	doctors, what appears to be best to clear up redness along borders of lips?
drburkhart	Tina, yes. But that does not mean that you cannot have several things-diseases going on at the same time.
RAG116	what is the best medicine to use for olp
JC11	vitamin E or anything else?
Sue	Drrees: I am using Protopic (tacrolimus ointment) during the 14-day period that I rest from the Temovate. Is that an okay thing to be doing?
Tina	Dr B Do you think that dry mouth really adds to your problem when you have olp?
DrsBrennanandFox	The natural course of OLP is to have flares and periods of remission. You are probably never "cured" but may go long periods without an active lesion.
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Judah	it's called "biotene oralbalance" - mouth moisturizing gel
Valerie	Type here I was diagonised with OLP over three years ago and it has not gone into remission. It subsides a bit and then will reoccur with a vengence. I use the biotene mouthwash and fluocinonide gel.05 daily. I have hear that a dermotologist can perscribe a stronger form of fluocinonide. Is it safe to use in my mouth?
drrees	Sue Protopic is a great drug for oral lichen plnus but the FDA has some concerns about its use. Discuss this with your doctor.
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drburkhart	Tina, yes I think so. So one is comfortable with a dry mouth. Water is certainly important as well. By keeping the mouth hydrated and avoiding caffine, you can do a lot on your own.
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DrsBrennanandFox	Tina - yes, We do think that dryness adds tothe OLP problems. With a dry mouth the mucosa is more sensitive and more susceptible to infection.
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JC11	Doctors, Is OLP related to lack of blood flow to the mouth, or lips?
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Eruta	I believe protopic has been black labeled. Any info on that?
drrees	Valarie yes there are other topical steroids that are stronger than fluocinonide. We use them often.
Nikkijo	o.k. I am not sure whom I am speaking with, but I am here to discusse my Erosive Oral Lichen Planus
ak	ak can lichen plantis turn into cancer?
Sue	Does SjS cause olp or vice versa?
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drburkhart	Everyone, if we miss your question, email me after the session and I will make sure we answer you. I can forward emails to Dr. Fox and Brennan
Tina	Dr B does olp affect your nails. I have had two toe nails that have come off. If so what can you use on your nails?
aupton	nikkijo - the format is questions to the doctors who will answer as they can.
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DrsBrennanandFox	Sue- There is no evidence that OLP causes Sjogren's or that Sjogren's patients have an increased incidence of OLP. They can occur together, but that doesn't mean they cause one another.
drburkhart	Tina, yes you can have lichen planus on the nails, scalp and vaginally. Essentially, anywhere there is lining mucosa as well.
Nikkijo	I have had my EOLP for 15 yrs now and I see Dr. Huber in San Antonio
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RAG116	i take clobetasol propionate for my olp and it saids external use only is the ok to put in mouth
drrees	Sue, as far as we know sjogrens does not cause olp or vice versa. However, the dryness one experiences with Sjogren's can make the tissues more sensitive ot OLP if it happens to be there.
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Nikkijo	My condition worsens yearly
JC11	Doctors, is OLP directly related with lack of blood flow to the mouth?
Tina	Dr B What can you use on your nails?
DrsBrennanandFox	Clobetasol can be used in the mouth.
Eruta	I have half of my littli pinkie nail that has gone. Any help to restore?
RAG116	is it the best medicine for olp
Roseanne	When I sleep I automatically suck the air from my mouth. Does that affect OLP?
Nikkijo	I am misserable for i am not able to go to my doctor for over a year now
drrees	RAG116 There are hundreds of studies that indicate it is safe if used properly and monitored. There is not enough time to discuss appropriate use right now but contact us and we can talk about it.
DrsBrennanandFox	JC11 - We are unaware of a connection between OLP and reduced blood flow in the mouth.
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flower	This is moving fast Dr Burk did I miss your answer about length of Nizral
Tina	Dr b Did I miss your answer on what you can do to help your nails?
JC11	Whenevr I work out or blood rushes to my head my OLP seems to improve
drburkhart	Tina, we have a dermatologist, Dr. Glass, at the stomatology center. I do not think that elidel is being used, but if you email me after the session, I will ask her to respond to you.
RAG116	can olp turn into cancer
Judah	Doctors - I have seen no mention of dexamethsasone here. What are your feelings and experience about it?
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Eruta	WHAT IS SJO. AND IS ALL DRY MOUTH CAUSED BY THAT?
Nikkijo	I use all of the meds and no cinnamon products, no carbonated drinks, spicy, hot ect...
Mimi	I've found it important to stick to Biotene toothpaste, or Orajel for toddler s... it contains no sodium laurel sulfate. I've also had problems the few times I"ve tried a whitening toothpaste.
drburkhart	Tina, I responded earlier as well
drrees	flower, I responded to your question. I think that you should avoid long term use if possible unless your liver fuction is tested often.
DrsBrennanandFox	Roseanne - mouth breathing is very common, particularly at night, and can make dryness worse.
Tina	Dr B Does olp turn into cancer?
RAG116	what is the best medicine for olp
Nikkijo	I can not open wide enough for a sandwitch for the pain of ripping my mouth, my lidocine is aony temporary and when its gone i fell the pain
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DrsBrennanandFox	SS, SjS, etc. are all abbreviations for Sjogren's syndrome, an autoimmune connective tissue disorder that causes dry mouth and dry eyes and other symptoms.
ak	ak what should you look for if olp does cause cancer?
JC11	Dr. Rees, can LP affect the inside of the nose, and lead to extreme dryness and even bleeding?
Eruta	oNE GOOD NOTE, aFTER 3 YEARS M THE lp ON MY BACK HAS DISAPPEARED
drrees	Judah, we havent had much success with dexmethasone. It is a good drug but used as a mouth rinse it apparently washes out of the mouth too quickly.
Nikkijo	is there more I can do to keep the canida infection away
Judah	thanks
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Bud	Type hereHi, I'm Bud. The message said "Disconnected. Connection timed out. Is the chat room over?
drrees	Bud, do you have a question?
Nikkijo	is there a stronger longer lasting lidocain out there
flower	Thank You Dr Burk have another question can you have LP in pubic area
RAG116	my question about medicine wasn,t answered
drburkhart	Tina, it is controversial. Any open lesion in the mouth may allow pathogens to enter the body. So it is difficult to pin point a direct cause. Most of the literature supports the fact that erosive(ulcer-like) lesions tend be more problematic in nature. So keeping lesions under control is crucial. The oral cancer rate from OLP is very low.
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DrsBrennanandFox	Nikkijo- I often have my patients use chlorhexidine concurrently with the use of topical steroids. This has controlled the side effects of fungal infection from a topical steroid well.
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drrees	RAG116. Ask you question again
RAG116	what is the best medicine for olp
Nikkijo	i have been told that the steroids cause my infections and am no longer allowed to use them
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RAG116	i have also been told steriods make it worse when it comes back
Eruta	ANY RESEARCH BEING DONE??????????????
JC11	Doctors, can LP affect the inside of the nose?
flower	May Sue leave her email address
aupton	eruta please turn your CAP LOCK OFF thanks
Nikkijo	I have perdoxil for the bacteria, and bioteen products
DrsBrennanandFox	Nikkijo- Yes steroids can often have a side effect of fungal infection, but with the appropriate anti-fungals the use of steroids is possible.
Tina	Dr B Is there any blood test for me to take to see if I may have another problem like my immune system, etc. Since I have been diagnosed with like a licha planus and have lost two toe nails?
drburkhart	Tina, you can have lp in the genital area. Many women go to the OBGYN and a connection is never made with regard to the oral lichen planus and recurrent yeast infections vaginally. All women should report this fact to their OBGYN.
drrees	There is no single best answer for that. We try to use the safest topical steroid that will keep it under control. If that doesn't work we go to something stronger but these is an increased chance of yeast infection in the mouth.
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Nikkijo	great! because i am really tired of the moment to moment pain of talking swallowing or even smilling
DrsBrennanandFox	Tina- I would have an internist evaluate you for symptoms consistent with other autoimmune disease. An ANA (anti-nuclear antibody) test is a start for a screen.
JC11	Doctor Burkhart, can LP affect the inside of the nose?
RAG116	i have been to different drs. and they all prescribe different medicine for me that is why i want to know what is best
MM	drs. has excessive use of Splenda-sweetend soft drinks been linked to OLP outbreaks? how about hi-protein diets?
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Bud	Doctors: I am 74 years old, male, good health. I have had olp for one year. The biopsy was "inconconclusive". My periodontis is not prescribing any treatment at this time. I was on flurocinide for a couple of months. I have no pain and I have plenty of saliva (no dry mouth) but my gums and inner cheeks look awful. Gums swollen at teeth line and innner cheeks have white coating, and spiderweb-like lines on one inner cheek. Does this tell you anything that I need
DrsBrennanandFox	RAG116- All patients respond differently to medications. I use temovate gel in many of my patients, but with other lidex or dexamethasone elixir is more appropriate.
Nikkijo	the erosion is continues from the lower left all around to the left of my inner lip, down my throat, under my toung
RAG116	since it is an autoimmune disease does that mean i will catch many illnessea please answer
drrees	I think we should all remember that sometimes something like a specific medication can cause a so called lichenoid reaction. There is a list of drugs available on the website that names some of those. If that is the case then stopping the causative medicine can stop the olp.
drburkhart	JC11, I am trying to think if I have seen anything directly related to the nose and I can't think of a single article. However, the lining of the nose would be vulnerable to Lp just as any other tissue would be, I think. I get emails from patients who have it all over the body so it would stand to reason that you could.
DrsBrennanandFox	RAG116- No. There is no evidence as OLP leading to other autoimmune conditions.
drrees	RAG116- The autoimmunitity of olp appears to be strictly local
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Eruta	drs. :have been using Vanicream over my entire body .seems to help.Any comment?
pjp1234	Type heredrs> My dermatologist puts me on an antibotic,prednisone and protopic along with betaamethasone which always gets my symptoms under control. Is there any danger with any of these treatments.
Roseanne	Other than medication, what can we do to reduce/help OLP?
Nikkijo	i read earlier the question that someone placed before ya'll "does this cause cancer?" even for as many years that I have had it
Tina	Dr B is there any other cream to use of olp other then triamcinolone acetonide. That is the hardest stuff to apply?
JC11	DR.B, my nose gets so dry, and even bleeds sometimes, also I hear what seems to be liquid in my right ear, not the kind you get after swimming, could all of this be related?
j	Dr. is there any one Speciality that handles olp and op.
Nikkijo	I so agree with Roseanne
KAS	I take over the counter meds for sinus problems. this seems to cause my lp to get worse. Is this because these meds have a tendency to dry my mouth even more?
drrees	Eruta, I don't know what vanicream is but it sounds like a soothing lotion. If so it may help symptoms but not be an effective treatment.
pjp1234	Does dry mouth always accompany OLP. I don't seem to have that problem
Tina	Dr B I have same ? as above if there anyone specialist that really knows a lot about olp?
drburkhart	JC11, I probably missed some of your previous posts but I hope you are seeing a really good ENT person to deal with some of this. You should be able to be treated for most of this.
Eruta	Did not see an answer to my comment re protopic being Black boxed?
drburkhart	Tina, yes there are. Email me and I will find one.
drrees	i-dentist, oral medicine specialists, periodontists, oral surgeons, dermatologist
drrees	Eruta, what id you want to know?
JC11	I talke to Dr. Rees for the first time a few weeks ago in person, I am hoping we can releive these symptoms.
RAG116	i need a dr. who knows something about olp i am finding out many know nothing about it
Judah	after seeing 5 doctors, including internists, dentists, dermaltologists, it was a neck and throat surgeon who eventually diagnosed my OLP
drburkhart	One point for everyone, we discourage the use of alcohol and alcohol mouthwash for all mucosal disorder patients.
Nikkijo	My Dr. at the Texas Health Sciences Center of San Antonio is the only specialest that I have found, and I adore him, but he is over 350 miles away
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DrsBrennanandFox	pip1234- No, dry mouth does not always accompany OLP, but if dryness from a medication side effect or Sjogrens is present then OLP may be more sensitive.
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Eruta	is it true that protopic has caused cancer in some users?
RAG116	it is so frustrating that they don,t know can if affect my throid where a just had a nodule checked for cancer
pjp1234	My olp started within 3 weeks of a dental cleaning. Any connection there?
RAG116	mind started with a tooth restoration anything to do with it
JC11	Dr. Rees, if my mouth looke like allergies but the test results were negative, what are the next set of tests or possibilities?
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Nikkijo	I have turned into a health nut and turned for help at the M.H.M.R for stress maitanance
ak	ak i have had olb after teeth cleaning.
drburkhart	pip, do not let the hygienist use an air polisher on you or abrasive dental products when you have a cleaning. We have some guidelines posted on the site which address this issue.
aupton	Everyone. The doctors will answer all the questions they can in the hour. If you miss an answer, the transcripts will be posted tommorrow on the web site.
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Mimi	Doctors, thank you for your time - this has been very informative..
Nikkijo	o.k. thanks
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ak	ak can stress cause an episode of olp?
JC11	Thank you!
RAG116	doctors thankyou sooooooo much but would like to talk further sometime
drburkhart	Everyone, don't hang up yet. We still have time.
DrsBrennanandFox	AK- Many of my patients show a strong relationship with stress and OLP
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drrees	Eruta- That is an unanswered question. The FDA has decided to place a warning that it might be assoicated on occasion with cancer but there is not enough data to know one way of the other. It will take a long time to find out so FDA suggests that it only be used for specific purposes if other treament fails. We have stopped using it in our clinic until we know more but that is an individual decision. Discuss this with the doctor who prescribes it for you.
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RAG116	i am not what about mt throid nodule is it related olp
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Nikkijo	I thank God that ya'll even take care to notice to us!
flower	Dr.Burk I'm wondering since someone mentioned it I have been taking Claritin fo almost a year and now my OLP is back. I have had no problem for 2 years
JC11	Dr. Rees, what is an email or contact # I can get in touch with you at?
aupton	Everyone. Still 15 minutes for the doctors to be with us. Afterwards, I will leave the room open for about 5 minutes for exchanges with each other.
pjp1234	Didn't get an answerabout my drs treatment and the possible dangers of prednisone and protopic
Eruta	Any support groups in the flesh in Arizona?
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Tina	Dr b any thing else other then triamclnoione dental paste. Hard to apply and feels like glue in the mouth?
drrees	JC11- my e-mail address is on the web site or contact Dr. Burkhart.
Nikkijo	o.k. I will take my leave then, just the one question is the most important to me is-
JC11	ok thank you
MM	drs; any connection w/Splenda consumption?
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pjp1234	Any support groups in metro DC area?
drburkhart	ak, yes I think stress is reall a key factor. If you think about it, most patients can tell you that the outbreaks occur during stress related times. Stress reduction is good for anyone. We as a society are over worked and under great stress! Try massages, yoga, tai chi and be good to yourself!
DrsBrennanandFox	Tina- There are many other steroid formulations. Please check with your doctor.
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tessa8898	Is anyone else having a hard time keeping a job?
Bud	Can you give me the name of a good tooth paste? I tried Biotene but it burns a little. Now I am trying a children' s tooth paste called "Dr. Burts."
RAG116	can the effects of some dental work hurt olp
drburkhart	Tess, job stress is a big stressor! And, the loss of a job can even be worse.
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flower	how about Splenda, bad?
RAG116	like the mercury in some fillings
Mimi	I think an excellent toothpaste is Orajel (toddler) training toothpaste... contains no sls
Roseanne	Drs., these sessions are most helpful. Thank you.
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Nikkijo	i have had mine for 15 years and only one biopsy to check for cancer, that was 2 years ago can it still occur
Nikkijo	?
DrsBrennanandFox	Bud- Many tooth pastes have flavorings that people react to, I would make sure at minimum the toothpaste has fluoride. If you have sensitivity, avoid tartar control and whitening toothpastes.
Eruta	Any info re the incidence of LP throughout the USA.
Nikkijo	God Bless, bye
Tina	Dr B what is a good cream to apply daily? I may have missed your answer. Triamcinolone Acetonide dental paste is what they prescribed. Like I said feels like glue> I'm hoping you can answer this ?
Sue	drs: Is there any tooth whitening product or procedure that will not cause deterioration?
drrees	Bud, I don't know about Dr. Burts. We try to tailor the toothpaste to each patient's particular situation so I don't know quite how to answer that. You might try regular Colgate however, with no peroxide, tarter control or whiteners.
aupton	Thanks, Nikkijo
j	any info re the incidence of olp & lp in Canada?
tessa8898	DrB, I Can't find a job that will allow me to have water at my desk, etc. I was a AVP in the banking industry for over 25 yrs.
Eruta	What is the incidence of olp andlp in the US. Anyone know?
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drburkhart	Nikkijo, yes it can. You should be monitored by your doctor and rechecked periodically. If changes occur, a new biopsy may be needed. Oral photographs that can be compared are a really good idea. No one remembers exactly what the lesion looked like 6 months ago.
drrees	Eruta and i- probably somewhere between 1 and 2% of the adult population
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DrsBrennanandFox	I am not aware of a connection of Splenda and OLP, but there may be other health concerns.
RAG116	why don,t most drs. know anything about olp
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drburkhart	J-I get emails from a lot of people in Candada-they are not immune.
RAG116	it is so frustrating
Tina	Dr B Good ? above ? was good incidence in Canada and what do they use for treatment?
RAG116	or how to treat it
Tina	Dr B How long has lichus planus been known?
pjp1234	Is lichen planus a new disease and is that why it takes so many drs to diagnose.
drrees	RAG116- most doctors don't get a chance to deal with many patients with olp. But more and more are learning about it.
Nikkijo	i can no longer open my mouth wide enough for another biopsy, the tissue heald -kind of- but the flex is all but gone
aupton	Everyone, the doctors will be with us for another 10 minutes.
RAG116	ok thanks
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drburkhart	Tina, they are using the same things we do.
DrsBrennanandFox	Nikkijo- Was this due to scarring?
pjp1234	I feel like the lining of my mouth has shrunk. Is that possible?
RAG116	why is olp just coming out now and what causes it
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Nikkijo	i do believe so
Tina	Dr B I hope you answer this ? before you leave, how long has lichus planus been diagnosed in people. People must have had that years and year ago. How did they treat it?
JW	Doctors, doesn't using lidex gel thin the skin on the cheeks?
drrees	Tine and pip1234. Lp was first recognized about 150 years ago. It was only recognized as occurrintg in the mouth about 50 years ago.
Nikkijo	they fixed one of my teeh with pins because all of the tissue has eroded
RAG116	i feel so helpless that no one can help me for this miserary in my mouth it is depressing
Tina	Dr B how did people treat it then?
Nikkijo	around the gum line
drrees	JW, yes on skin, maybe on mouth tissues but that has not been a problem for our patients
DrsBrennanandFox	JW- One potential side effect of topical steroid is a mucosal atrophy, which may lead to thinning of the tissue in theory.
Nikkijo	if feel like hard dead skin
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Tina	Dr B Is there a lot of research going on regarding olp and the cause and treatment of it?
drburkhart	Tina, sorry I lost you. Are you talking about the people in Canada?
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Coro	Dr. B. - Can you reccomend a resource that I can share with my GP, Cardiologist, dentist and other health practitioners?
aupton	Everyone, please begin concluding your conversations. The doctors will be leaving in 5 minutes. No new questions, please.
Bud	I am taking 1000mg of Black Currant Oil that contains Omega 3 (ala). 6(gla), and 9 in it. Is there any information about the benefits of this?
RAG116	it seems the doctors in india know a lot about olp
Sue	drs: thank you for your time
drrees	Bud-no
DrsBrennanandFox	Tina- More research is occuring in the field of OLP, as more in found out about the pathophysiology of the condition.
RAG116	yes doctots thankyou very very much
Mimi	Again, Thank you, Doctors!! I wish you all a wonderful day!
Nikkijo	again thatnks even if q's were not answered this helps a whole lot just to vent, THAKNS bye
Tina	Dr B Thanks for this session and I hope that by the next session we will have more on a cure. I hope it's not just wishful thinking.t
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Nikkijo	amen Tina
JW	All doctors, thanks so much. This helps so much.
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flower	I will leave my new e mail address so anyone has the same symtoms as I do can contact me after reading the transcript Thanks to the Drs I get a lot from this chat
drburkhart	Corol, we have some articles posted on the site and there are several new ones that appeared in the J of oral pathology and oral med. by Dr. Lodi, et al email me and I will give them to you.
Bud	Thanks Drs. Rees, Burkhart, Fox, and Brennan.
Eruta	Misery likes company so thank you for this
drburkhart	Thank you everyone for the great responses. Email me and I will get back to you.
aupton	Everyone, the transcripts will be on the website tommorrow. Drs. Rees and Burkhart's email addresses are on the Web site. Thanks so much to our guests, and please begin signing off now.
rae1	rae Thanks for very informative session
RAG116	hope we can do it again soon
flower	rclinda@ psci.net
RAG116	it went aweful fast
Tina	Dr B When is next session?
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DrsBrennanandFox	Thanks everyone for your interest and outstanding questions. Be well.
drburkhart	Thank you Mike, and Phil and talk to you soon, Terry.
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aupton	Next session will be announced on the web site.
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aupton	Sign up for the email announcements on thje Web site
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drrees	Mike and Phil. We really appreciate your participation. i hope you enjoyed it.
pjp1234	To those who have lost nails, so did I but they are growing back after just a few months so hang in there.
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aupton	pip no cross talking, thanks.
pjp1234	Thanks to all the Drs for their time
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aupton	Doctors: thank you so much for your participation.
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j	pjp thanks for the info on nails
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aupton	ak, thanks for joining us. Please click the log off button to exit the room. Hope to see you next time.
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