Log file 060999.html for
Chat room Dental_Study_Club
-- Log on 060999.html started at Wed Jun 09 14:43:13 PDT 1999
aupton Welcome, the doctors will be with you in a few moments.
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drburkhart Good afternoon ! As we begin the session this afternoon, I would like to make some general comments. We have received a few inquiries in the past months about teeth bleaching and whether patients who have oral lichen planus should have the procedure performed. We really do not have specific data related to lichen planus, but we suggest that any bleaching should be performed under the care of a dentist. We can say that any type of irritant that is placed on tissue tha
drburkhart The second item that is of concern to us is the use of corticosteroids/steroids and nursing mothers. We have received inquiries about the use of these medications and the effects that may be encountered. Any patient who is pregnant, believes that there is a chance that she may be or is currently nursing, should talk to the physician or dentist about adverse problems and concerns.
drburkhart The next item that we want to address is our current survey placed on the site. The responses have been from all over the world and have included both the patients and many practitioners. The survey helps us to know if we are helping all of you; but in addition, the survey provides us with some valuable data that may indicate some relevant patterns that may be occurring in cases of lichen planus. So, if you would please take the time to complete our survey over the
drburkhart We continue to receive excellent feedback from all of you about the page, emails and discussion groups. Thank you for all the kind comments. If for some reason, your email was not answered, please contact us again. As you know, there are times when we are out for extended periods of time or our system may be down.
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drburkhart Hello Jan, how are you?
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Jan Type HEREDoing OK, thank you
drburkhart Have you chatted with us before and do you have some questions for us?
drrees Hi Dianne, did you see Dr. Burkhart's info that intriduces this session. We hope that will provide some useful facts. Is there anything you would like to discuss tonight?
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Jan I have never chatted here before, however, have read some other transcripts
drburkhart Do you have lichen planus? If so, tell us about your particular case.
Jan Will you ask us questions individually, or do we just jump in?
drburkhart Jan, just jump in and ask any questions that you have or make any comments.
Dianne Dr. Burkhart and Dr. Rees Have you received my e-mail?
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Jan My dentist told me I had Liken Planus and sent me to an oral surgeon for a second opinion. He agreed. I had painful sores on my inside cheek
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drrees Dianne-Yes, but as you know we have not yet responded. Is there any part of it you would like to discuss tonight?
drburkhart Jan, have you had a biopsy? What are you currently doing for the lp?
Dianne I am interested in L.P.in the ear if anyone know of that I would be interested to hear
Jan No, I have never had a biopsy, neither Dr. suggested that. You are the first person who mentioned biopsy. Is that what a need for confirmation?
Jan I was scared to death that I had oral cancer, which is why I went to the Dentist in the first place.
drrees Dianne, we have never seen it in the ear but since it can affect skin there is no reason to think it can't occur there, but I doubt it.
drrossman Jan, lichen planus is not cancer and the best way to alleviate your fears is to have the biopsy done to rule out any other lesion.
drburkhart Jan, you are wise to have any oral lesion checked by a professional and oral cancer is certainly a concern that we all think about in these cases.
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Jan After I gave up tarter control toothpast, the lesions, although still there, are not as painful. I am concerned about the rashes on parts of my body. How will I know if they are LP? I was told I have excema
aupton Welcome Dots and CB. Just send a question when you are ready, and the doctors will respond as soon as they can.
drburkhart Jan, in addition , a biopsy will tell the pathologist what type of mucosal disorder you may have in your mouth. Oftentimes, the mucosal disorders appear similar.
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Jan Are there any parts of the body that are normally affected by LP. For instance, I have itchty rashes around my waist, wrists, backs of knees, neck and forehead
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cb Is anyone having success with tongue lesions using Lidex?
Jan I also have vaginal and rectal itching which comes and goes. I am trying to keep track if these rashes are worse when my mouth hurts the most
drburkhart Jan, the only way to know for sure is to biopsy. About 17% of lichen patients have skin lesions in addition to oral lesions. We also find that tarter control toothpaste do exacerbate the condition.
Jan I will definately have the biopsy. Thanks for the suggestion.
drrees Jan- it is not uncommon for LP to affect so called "flexor" surfaces of skin but your condition does sound more like exzema
Dianne I would like to share with everyone that my doctors and I thought that for the last several years my L.P. was running rampant. However at the last chat line Dr. Rees sugested to me that it may be a yeast also as yeast will present itself differently in our situations. My doctor prescribed an anti - yeasr med 9nystatin0 and sure enough my mouth subsided and I could eat and talk again in peace. Many thanks to Dr. Rees and the Chat Line we have here. Hooray from Can
drrees CB- yes we have had good success with Lidex but sometimes it takes a stronger steroid
Jan Is nystatin an oral medication? A pill?
Jan I use Lidex for the rashes on my body - how would you put Lidex creme in your mouth?
cb I have plaque like How do I know if the pain or discomfort from the OLP is really due to yeast?
drrossman Jan, Lidex gel (0.05%) is recommended for the mouth since it has some staying power.
drburkhart Jan, it is usually used as a rinse. The lidex is used as an oral ointment but in a gel form.
cb One just applies the lidex gel on the lesions with the finger.
drrees CB- the plaque-like form could be a variety of different lesions. Yeast infection is one but that is not too likely. Have you had a biopsy?
Jan Does the lidex gel diminish the pain immediately?
cb Jan-Lidex takes a few days
drrossman Jan, Nystatin can be applied in several ways. An oral suspension used as a rinse or in a troche that is melted in the mouth.
drburkhart cb, no, we recommend a cotton tip applicator. If you go to the original page of our site, we have some step by step information on how to apply corticosteroids medications.
Dianne Jan Nystatin in an oral med. Also My vaginal and anal itching responded to Mycatin.
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aupton FD welcome. If you have a question, the doctors will respond as soon as they can.
Jan The oral surgeon told me to make a mouth rinse out of benedryl and kaopectate.
drburkhart Dianne, there is a lot of information about the connection of vaginal and oral lichen. Have we addressed this issue with you and sent you some articles?
cb Dr Rees, I had a biopsy about one year ago. It said "consistent with LP" I have not had one since but may opt for one with my new Dr., dr. Mike Siegel who has been trying to work with me
drrees Jan- that will make you more comfortable but it has no curative properties.
Dianne Dr. Burkhart no you haven't but I would sure like some info thanks
drrossman Jan, the use of a mouth rinse with Benadryl and Kaopectate is helpful when the lesions or ulcers are painful. It acts as acoating for relief.
Jan I wold love the information abut the connection of vaginal and oral lichen. Is that available on the web page?
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Dianne diannedoucette@hotmail.com
Jan Should we avoid mouthwash? I haven't used any because it is too painful but is there a brand we can use?
drburkhart Jan, no we really do not have the information on the page as of yet, but I can mail you some copies of current articles. Dr. Drore Eisen has written a few good articles on the subject.
Dianne I have started using Biotene toothpaste and mouthwash and find it helpful
Jan That would definately be apprecited
drrossman Jan, the mildest brand of mouthwash is called Biotene and should be availabel in your drug store. It contains no alcohol which is what makes the other brands too painful to use.
drburkhart Dianne, Yes we find that biotene is a paste that patients tolerate very well.
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cb To all Docs- My current Doctor has a hard time figuring out why I have this at my age, 31 and why only the dorsal surface of the tongue not elsewhere. Is it that rare at this site? I will do another biopsy if he wants but I am afraid of doing more harm in my mouth. It seems that eversince the OLP, my entire mouth-palate, gums inner lips have been very reactive to everything. I am afraid that biopsy will aggravate things. What do you thin?
Dianne Is there anyway we can be involved in your study groups from a distance?
Jan I have no leisons on my gums but I am concerned that my gums have recently started receeding
drburkhart To all: Do any of you have concrete connections that you have noticed in relation to your own lichen pain or ulcerations?
Dots Type HEREI want to thank Dr Burhart and Dr. Rees for giving me Dr. Stephen Sonis at Women & Brigham in Boston. I saw him once and we talk everyweek by phone. He perscribed IC Fluocinonide 0.05% gel which I used three times a day to begin. Now I only use at bedtime and my mouth coming along nicely. I am very happy to feel so good. In sept. he recommends a biopsy. Thank you for your help!
Jan I am 54 years old and I take prempro and also thyroid medication. Could these medications be making matters worse?
Jan I have not established a connection to my medication but I am wondering
Dots I would also like to be involved in your study group from a distance.
drrossman Jan, the lichen planus may involve the gum tissues and could result in recession. It is best to let a periodontist evaluate your condition. I might add, we have not had good success in treating recession defects in patients that are currently effected by lichen planus. You might wait for treatment to the recesson, until the LP is quiet.
cb Dr.burkhart, , the ulcerations occur for no apparant reason. the plaque is alreaady sensitive so if I eat hard things, it breaks the tissue a bit. Otherwise, I cannot make any significant connection with anything. It seems to be everything.
drrees CB- We have seen the plaque-like form on the dorsal of the tongue. It does not always respond well to steroids. I don't think a biopsy will do anything except make your tongue sore for a few days. I also think that a lesion that persists should be re-biopsied periodically, i.e. at least annually
aupton Diane, concerning distance study groups, the web site and these live chats are what we have available at the moment. If you'd like to drop us a note by email about the type of distance study you have in mind, I will respond.
Jan Once, I used a Zinc cold lozenger . That definately made the lesions worse
cb To the docs, What do you think about retinA,also a suggestion offered by my current Doctor
Dianne Jan me too
drburkhart Dianne, as a participant in our site, you really are an active member that contributes to the group. Anything that we say here tonight is posted and anyone is able to read all these comments. Support groups provide information, a sense of sharing and promote research in a particular area. Tonight we are providing all three aspects. By completing the survey on our page, we will be able to tabulate the information and study patterns of all the participants.
drrees Jan-when you have mouth sores a lot of things will make them hurt. the rule is, if it burns, don't use it.
Jan Are mostly menopausal women affected by these mouth sores - are men affected?
drburkhart Dots, You are in good hands with Dr. Sonis. He is an excellent practitioner and certainly knows a lot about lichen planus.
drrees CB- We have had reasonably good success with retinoids for your type of lesion. However, it should ber used carefully and monitored closely because it can actually cause your lesions to become erosive. If your doc recommended it and will monitor, then I'd suggest trying it. By the way this does not apply to others on the site tonight.
cb Dr.Rees, would the erosions become a permanent phenomenon if I start retinA or would it subside once I stopped?
drrees Jan- you ask an interesting quesion. the majority of our patients are female but men get it too. The majority of females are postmenopausal but we think that is because the disease affects individuals past the age of menopause.
FD Dr.Burkhard,
Dianne Has anybody tried not eating for a few days or only tried eating bland liquids to see if healing would be fostered?
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Jan If you have lesions only in one part of your mouth for months, what are the chances of getting more lesions?
drburkhart Jan, Yes, there appear to be more women in the post menopausal age group that report lichen planus. However, men in this age range are diagnosed with lichen also. Research supports the fact that women seek treatment more often than men, as a rule, so we are really no sure about the demographics. Hopefully, our survey will provide some information on this question.
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drrees Jan- My response looks confusing. What I'm trying to say is that age is probably the biggest factor here. We have done some studies but have not been able to find a connection with hormonal imbalances.
Jan Does this mean there are no found connection between this and thyroid disease?
drrossman Jan, since the cause of LP is multifactorial, you can get more lesions simply by increasing your stress levels, or having a food substance that aggravates the condition.
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aupton FD, do you want to ask Dr. Burkhart a question? If so, type her name and the whole question before pressing Enter.
Jan I avoid citrus fruits and juices.
Jan Ketchup burns also
Jan I did try a bland diet when the lesions were really painful, I actually had no choice
Dianne I had L.P. first diagnosed when I was 31 yrs. and had already a hysterectomy at age 25 yrs. Any conection. I also have a thyroid cond.
drrees Jan- LP often affects only one site but it is perfectly capable of involving other sites so don't be surprised it that happens. Medication that works for one site should work for all. Jan- No there doesn't seem to be a connection with thyroid deficiency. Most of the patients we see who are thyroid deficient are already taking thyroid hormones.
drrossman Jan, you may also find that red wine will burn and aggravate the condition.
drburkhart Jan, we have received a number of emails from patients who also report a citrus/burning connection.
Dianne Jan did it help/
cb teas, tanins, EtOH, all contribute to some pains on the lesions, for me
Jan Yes, I do think it helped a bit but when they are really painful, they just plain HURT
Jan I increased my water intake - for some reason, I think that might have helped.
drburkhart To all: Have any of you been able to document a stress/lichen planus connection? Does it get much worse during times of stress?
drburkhart To all: have any of you been to a stress management seminar or participated in such a group?
Jan Yes, I can connect that it gets worse during stress - but not always. I had a very stressful situation recently and my LP was better than it had been in ages, Go figure
Dianne Dr. Burkhart I found citrus burning problem was actually do to an oral allergy to certain fruits. Oral Allergy Syndrome.
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drburkhart Dianne, how was this confirmed? What information did you get about the oral allergy syndrome?
Jan I never thought I needed stress management, maybe I should do that also.
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Jan Do any of you get lesions in the roof of your mouth?
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Dianne When I first was diagnosed it was at a very stressful time. I have a lot of stress in my life and I believe they are somehow connected and yes I have tried a stress management course but fine it hard to play tapes etc. I guess I have refreshed my mind to something here. thanks.
Jan I am also wonderingif the lesions cause bad breath?
drburkhart Jan, Since we do not know you personally or know of your life-style situations, we can't say that you truly need stress management. However, it is usually beneficial to most everyone.
cb Jan, describe a "lesion" I get a burning sensation on my upper palat sometimes but cannot see anything by looking. It is also hard to look up there.
Dots If LC in an autoimmune condition what can we do to strengthen our system?
Jan I feel like I have a sore in the roof of my mouth, it doesn't look the same as the LP on my cheek, it's a red blotch and it hurts
drrees Jan- any time you have mouth ulcers or other open sores it can cause bad breath. In addition it is often hard to clean your teeth when your mouth is sore.
Jan I do know that breath mints make the LP much worse
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drburkhart Dianne, any type of relaxation is beneficial. Exercise, yoga or relaxation could help. Sometimes, just finding a type of exercise or relaxation technique that fits your personality and life-style is the key.
cb Jan, where is the location of your most painful lesions. Are those lesions constant/ Do they ever completely dissappear and reappear elsewhere?
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drrees Jan- you need to have that checked. It could be yeast, LP or something else.
Jan The thing on the roof of my mouth is not constant, however, the LP on the inside of my cheek is always there
drrossman Jan, the bad breath is generally from a build-up of dental plaque which is the result of not effectively cleaning your mouth when it hurts or is too painful to touch. I would suggest a mouthrinse without alcohol to relieve the odor. Best would be a chlorhexidine mouthrinse , but it has to be made in a local pharmacy to be without alcohol all the commercially available products contain alcohol.
Jan Does the biotene mouthwash you mentioned have alcohol also?
cb Jan, that is interesting because I have the smat problem with the tongue lesions being there always and the palate thig coming and going. The palate thing is not really red though, just burning
drburkhart Jan, Are you close to us here at Baylor or do you live in another part of the country?
Dianne Dr. Burkhart it was confirmed by an allergy specialist from scratch test. It is something to do with cross polinations from trees.
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Jan I don't know where Baylor is?
drrossman Jan, the Biotene mouthrinse does not contain alcohol.
Dots Exercise helps me most. Walking, jogging, winter sports and summer sports. My jobs is physical also. Lots of walking and light lifting. (Garden Center)
drburkhart Jan, we are in Dallas, Texas.
Jan Oh, I am in upstate New York.
cb Does anyone have a problem with excessive salivation and constant dry mouth and bad taste?
Jan No
aupton Everyone, we have about 5minutes in this session. Please begin winding your discussions down. The transcripts will be posted on the web site tommorrow.
Dianne The fruits I am allergic to and that burn my mouth are as an example bannanas kiwi melons grapes etc.
Jan I feel that I learned a lot this evening and wish to thank everybody. I am making an appointment for a biopsy
cb Doctors, Is the salivation, dry mouth and bad taste common in OLP?
Dots It is hard to think about what foods, drinks and stuff effect my mouth?
Jan I would like the information connecting the LP mouth and vagina
Jan Lemonaide kills me
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Dots I would also like information about LP and VLP which I am presently in remission. Yahoo
Jan My mother always tells me to rinse with salt water, even if it burns. Is she wrong?
drrees CB- excess salivation can occur when your mouth is sore. The dry mouth and altered taste may be due to medications you are taking or a few different disorders other than LP
drrees Jan- Yes.
aupton It's time to say goodnight, folks. The doctors will be logging off shortly. We appreciate everyone's participation tonight. Keep watching the web site and your email for the dates of our future chat sessions.
drrossman Jan, the adage is if it burns, don't use it!
drburkhart FD, do you have any comments or questions? We are happy to just have you listen but don't want to over look you either. You also may reach me by email with any follow-up thoughts after the session. My email is on the original page.
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drrees Hi, Bill- sorry we missed you.
Jan What a very useful tool this has been, Many thanks
Dianne thanks folks
drrossman Thank you all for your participation.
drrees Good night all, thanks for participating.
Dots thanks you...
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Jan Dianne, I copied your e-mail address. May I e-mail you?
Dianne Jan yes of course
Dots Thanks to Dianne also. Talk with you soon
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Jan Misery loves company
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Dianne Great ... I love chatting with all of you. Makes L.P. a l.p.
drburkhart Thank you all for participating tonight. If you have any thoughts or comments for us, please send us an email. We are receptive to new ideas and we want to continue to meet all of your needs with regard to lichen planus education.
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FD FD[Dr.Burkhart] Is sleep apnea a contributing factor?Also a Dry mouth from Medacation?
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aupton fd, drburkhart will answer you.
drwathen goodbye, all. Thanks for letting me "sit in"
FD Thank you ! I guess the Sleep Apnea is my concern
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aupton fd, dr burkhart is composing an answer to your question now. Wait just a moment.
drburkhart FD, we have not seen any reports about this in the literature. I will say that dry mouth has some effect on the tissues, may promote candida and generally makes you uncomfortable.
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FD Dr , It would be interesting to see just what we have in common ,thing we are not covering etc.
aupton Folks, our local network will be shutting down for a 're-boot' any moment now, so thank you all for participating.
drburkhart FD, the school will be shutting down soon so Please email me directly with your questions and we will get some answers for you.
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-- Log stopped at Wed Jun 09 16:02:27 PDT 1999
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