Transcript Mar2003 for #Dental_Study_Club

Log file Mar2003 for
Chat room #Dental_Study_Club



.............. Log on Mar2003 started at Thu Mar 20 06:07:57 PST 2003 ...........
aupton room/open

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aupton ru -- please hold your questions. The doctors will be with us at the top of the hour

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aupton hello, dr lewis Nancy will be with us in a moment
drlewis Great.

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aupton Judy hold your questions until all the doctors are online at the top of the hour. Thanks, and welcom

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aupton keg, please hold your questions until the docs are all on at the top of the hour. Thanks and welcome

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drrees Type here Hi Michael, It is good to have you with us today. I don't think I've seen you since Dublin a long time ago.
drrees Terry

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aupton The reason we're holding topic questions until the top of the hour is that people who come on later cannot see what has been said, although it will all be on the transcript
aupton elsie, welcome. please hold your questions until we say go.
aupton we will begin in 4 minutes
drburkharrt I would like to let everyone know that we have had a large number of emails to the site recently and if for some reason you have not received your response, we will answer soon. Email us again if you think we may not have gotten your email.
drburkharrt Hello Mike and Terry

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drlewis Hi Terry. Yes, it was Dublin - too long ago. Lets hope we can meet again soon. I had a good time with Bill Binnie at IAOP recently and he filled me in on the Baylor news.
aupton participants have your questions ready for the doctors. They will answer in order and as they can, so be patient. No "cross chatting," please. Talk directly to the doctors.
drburkharrt Everyone, there will be time at the end to talk to the other participants and to exchange emails.
aupton Good morning, everyone, and welcome to Dr. Lewis and our hosts, Dr. Burkhart and Dr. Rees
aupton Let's begin
Judy I am taking toprol and glucophage and wonder if this is agravating my condition of OLP?
drrees Judy, we don't have any reports of either of those drugs causing a lichenoid reaction. In theory though any drug can do that for someone. I would not worry about them at this point.
drburkharrt Hoke, Keg or Ru, do you have some comments?
hoke Good morning. Is there a risk of transmission of HCV by intimate kissing during a flair of erosive lichen planus?
drlewis many patients taking oral hypoglycaemic or other diabetic drugs seem to develop OLP. I am sure there is ofetn a connection. Did you have OLP before starting these drugs?

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keg i have old for 5 mox i am 60 yrs old and I took Cipro 6weeks before my first breakout is there some coonnectionsType here
drrees hoke, You've asked a question for which we don't have an evidence based answer. In my opinion that would be most unlikely.
aupton welcome, new visitors. please direct your questions to the doctors directly, and be patient. they will answer as soon as they can. no cross-chatting, please.
drburkharrt Hoke, with any open lesions, you do raise the risk of transmission. Have you asked your physician about this? Many new articles have been published regarding HVC and LP. We have some posted on the site.
Maryp Are we Lpers considered immune compromised?...something we need to consider b4 smallpox vacination.
drlewis Dr Hoke, I suppose any damage to the lining of the mouth could increase the liklelihood of transmission but I do not know of any studies to show this for HCV.or reduced any
Debs Is it unusual to have numbness & tingling in my lips? How quickly can symptoms come and go?
drrees Keg, I don't think I fully understand your question but if cipro was causing you a problem the lesions would have subsided within a short while after you stopped the drug.

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drburkharrt Hoke, we have an expert who has conducted many studies on HVC/LP. If you contact me after the session, I will put you in touch with him.
Judy I have had LP for about 18 years but it previously it has gone into remission. It continues to flare up. Anything I can do to make it less painful?
keg i've been to dr jacobsons office in san francsioco and now use magic mouth wash and lidx with orobase. this seems to help but the oral lesions , the white stuff is still spreading . what will the remission look like.s
drrees Mary, When we look at blood studies that reflect an immune compromised state, olp itself does not appear to affect those.
hoke I did ask my dermatologist who said there was no issue re: kissing & transmission. Thank you Dr. Burkharrt, I will contact you.
drlewis Dear Judy, What treatments have you tried?
elsie Good Mornin I am here for support for my mother as I have spoken with Dr burkhart about her
drburkharrt Hoke, do you have errosive OLP?
Debs Is having an elevated ESR a symptom of OLP?

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drrees Judy, we excect our patients to have occasional flares. You should probably restart treatment early when that happens and the lesions should not get as severe as before
Maryp Dr. Rees what type of treatment are u speaking of?
hoke Yes, I do have errosive OLP.
aupton welcome newcomers. address your questions directly to the doctors, and they will respond as soon as they can.
elsie she is 90 yrs old has has severe OLP and has given up hope now on help and treatment as nothin has truely helped her
drburkharrt Judy, Dr. Rees has some good information on the site regarding the application of topical products and we also have some new material regarding guidelines for recall appointments.
keg i now don't have open lesions but the white lacy stuff is still spreading. just because the lesions are better with the mouth wash is this considered remission.si
Maryp I am seeing a homeopath and my symptoms have improved dramatically!
Judy An oral surgeon has prescribed a mouthrinse but I'm not sure exactly what is in it. It makes my mouth numb. I also have an ointment to put on topically.
drlewis Debs, A raised ESR is a none specific indicator of inflammation or immune activity. ESR can be raised in active OLP.
drrees Debs- Not as far as we know. An elevated ESR is sort of a non-specific finding and it may sometimes just be associated with the aging process. It also is a test sometimes used to check for autoimmune diseases

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drburkharrt Hoke, are you taking medications?
aupton welcome, newcomers. the doctors will address your questions as soon as they can.
Judy My gums seem to be the most bothersome to me. It makes it very hard to do a thorough brushing.
merrillgerber merrill
Debs Is it unusual to have symptoms orally, vaginally, nails, lips, and possibly on wrists and ankles in the past too?
drrees Judy, If those things worked for you before, then that is what you should try again with the flare-up unless they are old and past their expiration date.
hoke What is the likely affect of OLP and skin LP with treatment for HCV: peg interferon/ribavirin? A worsening?
drburkharrt Debs, those are all common areas for OLP. All womenj whould let their GYN's know that they have OLP.
merrillgerber I'm using dexamethasone rinse: I've used it for seven months--I don't swallow, but wonder
merrillgerber what long term problems can arise from using this steroid

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drrees Judy, your dentist can prescribe an antibacterial mouthrinse to use while your gums are sore. It will help reduce the plaque levels.
drlewis Judy. A steroid cream held in place in a soft plastic splint for 10 minutes each day is a good form of treatment for OLP on the gums.l
ru Type hereMy oral surgeon prescribed nyastatin and all the white patches in my mouth cleared up???
Judy A large concern for me is the risk of this turning into cancer. What are the chances? Does it ever effect the loss of teeth?
merrillgerber Is nyastatin an antibiotic?
drlewis Ru Nystatin is an antifungal and therefore you must have had some form of secondary candidal infection.
merrillgerber Please discuss how long a s teroid can be used topically without serious side effects
drburkharrt Ru, you may have had a combination of candida and OLP which is common; especially when using any oral corticosteroids.
drrees ru- you had a yeast infection. If you also have olp the steroids sometimes used to treat that can sometimes make one more susceptible to yeast infections. We often have patients use an anti-yeast mouthrinse as a preventive when they use topical oral steroids
hoke Dr. Burkharrt, I am taking several Chinese herbs for HCV, Protopic for LP on skin and in my mouth and sometimes use Dexamethasone elixir.
drburkharrt Hoke, what are the herbs?
merrillgerber How does one know if cancida is in the mouth?
Debs would diflucan take care of candida in the mouth if it was present?
hoke have you got all day? there is a hand full of herbs. my herbalist is an HCV specialist and works with my hepatologist. I will be glad to send you a list of them.
ru the oral surgeon told me to stop using the cortisteroids.Said he didnot see olp
drlewis The risk of developing cancer in OLP is uncertain. However, it would appear to be increased if you also have a tobacco habit and drink alcohol. You will not loose your teeth.
drburkharrt To all: if you feel that changes have taken place and you have not been back to your dentist or physician, you should ask to be seen even if it is not time to do so.
hoke What is this splint you are talking about using for medication for OLP?
Judy Is there someone in the Chicago area that you can recommend I see for this steroid cream/splint?
drrees merrillgerber- when one uses topical steroids there is some evidence that a small amout of systemic uptake will occur. Dermatologist have to be very careful with this on skin since large areas are often involved. In the mouth the area is much smaller and there is less concern. We have some patients who have used topical steroids for years without problems but the strength of the steroid must be taken under consideration.
ru I am realy confused as to what I really have, Oral surgeon said no need for a biopsy, this was a month ago
elsie Hoke can I please get you to send this list to me also I know no cross chattin but
drburkharrt Hoke, yes please do. We get more and more information about the uses. It is interesting that your herbalist is working with your HCV specialist.
Debs would like a referal to a doc too please
drlewis Molecular techniques have recently shown that just about everyone has candida in their mouths, albeit in very low levels. Diflucan is an effective antifungal.c.tlow
aupton no cross chatting, elsie and hoke. time at the end for email exchanges
drburkharrt Debs, please contact me after the session and I will search for you nburkhart@tambcd.edu
keg when remission occurs, does the white lacy stuff disappear. I'm not sure what a remission looks like. please explain.no the white l
hoke is there any evidence that zinc oxide can help with lp on the skin?
drrees ru- It is very important to know what your oral surgeon's diagnosis is. Call him/her or visit and get that information.
elsie What about the use of the expensive cyclosporine been promisein?
drlewis I will send the reference for the splint steroid treatment for gum conditions to Dr Burkhart
Debs should the same meds be used orally and vaginally? (Triamcinolone & Protopic)
drrees keg- Remission really means a total absence of any lesions. We don't alwasys get that so we are often quite pleased if the white lacy form of olp persists in the absence of other painful types of lesions.
drburkharrt If anyone has information that they want to share with us, just send it or mail it to us. We consider and evaluate everything that we receive.
Judy How much does stress really affect the outbreak of OLP?
drrees DEbs- That would vary with your situation. Ask your gynocologist
hoke what about zinc oxide re: skin lp?
ru Oral surgeon said he was positive thatI didnot need a biopsy as His diagnosis was candida albicans. Who do I believe the Derm or the oral surg? I have had no lesions as well as all the thick white stuff has dissapeared.
drrees hoke- not that I know of except it may sooth the involved tissue which normally tends to itch.
drburkharrt Judy, good question. More and more we find that lifestyle factors play a large role. I really believe, as I have said for years, that modification to one's lifestyle can be significant.
Debs Are there any patient studies being done that I can participate in?
ru Saw the gyn and the eye MD... no Lichen
drlewis I have used topical ciclosporin mouthwash in a number of patients. The effects are variable 50% of cases improve initially. Topical tacrolimus seems slightly better.
drrees ru- right now the best choice is to believe the one who made the lesions subside.
merrillgerber Re diagnoses: the OLP specialist at usc said that since the lesions are there, and painful, there's not a real need to make a diagnosis: that is, treating the lesions has to be done in any case. Stopping all mymedications for other conditions would be difficult, and likewise stopping the oral rinse would make the mouth more painful

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drburkharrt Judy, stress reduction, relaxation technques, exercise, proper nutrition, tai chi, yoga etc.
keg the mouth wash I use had benadryl and dexamth and lidex mixed. this was prescribed by Dr jacobsens office. I also have LP in the vulva area. Temarate ointment was prescibed. are there any problems with these meds.. ea
aupton Welcome kathab. address your questions, comments directly to the doctors. they will respond as soon as they can.

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aupton hello. rosalie, address your questions to the doctors directly. they will respond as soon as they can.
drrees keg- the temavate may make you more susceptible to a yeast infection.
drburkharrt Keg, have we sent you articles on OLP/vulva, vaginal?
hoke Any opinion on the use of Curcuminoids for OLP? Also, any possible conflicts betw it and Interferon/Ribavirin?
merrillgerber (continuing re a definitive diagnosis: the original biopsy showed mucousitis and inflammation, both of the tongue and the cheek. Is it important to have further biopsies to identify OLP
keg No.
Debs Are there any patient studies that I can apply participate in?
Judy How often do you need to get biopsies?
drburkharrt Keg, contact me after the session and send your address. We have many good articles on the subject.
aupton Contact information is on the web site.
keg ok
drrees Debs, there are studies from time to time but that would depend on where you live and whether any are being conducted in your area.
elsie what to do when you have used all the mouthwashes,elidel,nyststin,lidex,protopic,plaquenil,steriods,antibiotics and evrything else mentioned and nothin has helped?
drlewis It is relatively straight forward to diagnose OLP on a biopsy and it can ceratinly exclude other diagnoses.
KathaB Hi. I have been using plaquenil for over a year now, and it's been a Godsend!
drburkharrt Debs, if you are close to a teaching hospital/dental school, you can check with them. Also, if you need some listings in your area, contact me after the session. By the way, please complete our research survey on the site.
Judy What is plaquenil?
KathaB It's an anti-malarial medicine.
merrillgerber Three drugs I use are implicated in OLP (these are hydrochlorothiazide, verapamil and imipramine); however, the dr said that even if these are discontinued, it might take a year to see if they are the cause. Once the body is stimulated to be inflamed, it may continue long after the stimuli is removed.
hoke Any answer to the probable effect on OLP & skin LP with HCV - interferon - treatment?
drrees elsie, have yourself checked for Hepatitis C infection. Check the medications you may be taking. Have someone evaluate the possiblity of an allergic reaction to toothpastes, mouth rinses, gums, dental restorative materials
Debs Thank you Dr B., I did complete the survey, also e-mailed for help but will do so again.
ru Does Lichen P ever go into remission without using anything?
Rosalie My OLP seems to be in remission or at least not bothering me although I have been given Protopic for the web-like sites on the inside of the cheeks. Should I use the topical cream if the sites aren't bothering me or wait until they crank up? I am now having LP rash on wrists, thighs and shins and using Clobetasol on them.

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keg since i don't have lesions now but redness and the white lacy appearance is stll present then i should continue my mouthwash but is it ever safe to stop the meds? it safe
elsie does chobetasol cream help the rash?
drrees hoke, The irony is that Hepatitis C seems to initiate lichen planus but on rare occasions the medications used to treat hepatitis may cause a lichenoid reaction. The timing of the occurrence of your olp might she some light on this for you.
drlewis Ru OLP can go into remission without treatment. In some patients it made return at times of stress and anxiety. rn
elsie What if Hep C has been ruled out?
Rosalie Yes, the clobetasol helps the rash. I have one site on the calf of my leg that isn't responding as well.
drrees elsie, we use clobetasol a lot but we prefer the gel instead of the cream. We think it stays in place longer in the mouth.
drburkharrt Hoke, there appears to be a mixture of people who are HCV and do not have olp and those on different medications. Let us connect you with those who are conducting research in this area. There is much going on at this time.

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drrees elsie, Then proceed with the other things I just mentioned.
elsie Does OLP cause hair loss also on scalp?
hoke what about the mouth split... what is that?
Debs Can LP go into remission in one area of the body, yet grow and become errosive in another at the same time?
elsie My mother is going bald I do believe from this now also?
drrees elsie, you shouldnt have hair loss just because you have oral lichen planus. If you have lesions on your scalp you need to discuss that with your dermatologist.
elsie thanks
hoke it is sounding like lp is associated with advancing age. is that correct?
ru What exactly does Lichen pl look like in the mouth and on the skin? Need a clear picture. Does any one have these pictures? e this
drlewis Hoke. The mouth splint is a soft plastic sheild that fits round the teeth and gums. It is a good way of holding steroid cream against the gums for 10 minutes each day if they are affected by OLP.
drburkharrt Just a note: Sometimes we find that one healthcare provider does not know what another is doing. If the patient can make sure that everyone is on the same page, it could work well for everyone. If women go to their GYN, but do not mention that they are diagnosed with OLP, it is sometimes overlooked.
elsie what can you do when someone gives up hope on all this?
hoke if it is associated with aging, why is that true?
drrees Hoke, the average age of our patients is 58 so I quess the answer is yes. However, remember that us older folks have more medical problems and are taking more medications that can cause the problem.
KathaB Elsie, what doseage of plaquenil were you using...I'm surprised it didn't work
aupton ru - there are some LP pictures on the web site both in mouth and on skin.
drburkharrt Hoke, I have gotten several emails recently for young adults and we have children who have OLP
Judy Do you see a dentist, oral surgeon or periodontist to get this plastic shield?
elsie Kathab this is me from OK
aupton NO CROSS TALKING, FOLKS, PLEASE.
KathaB Oh~! Hi!
KathaB sorry

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Judy Please recommend someone in ths Chicago area to see for my condition.
elsie sorry
Debs I'm 43 and have just been diagnosed but have had symptoms for many years, is this strange?
aupton We'll have time at the end for exchanging emails
drlewis Judy. Any one of these doctors can provide a splint.
keg if taking meds can cause the olp and I took Cipro which is a drug I never used before and the OLP didn't show up for 6 weeks after, then what causes OLP. at the time of my first breakout I was on vacation.uthen ha
drrees Judy, any of those should be able to make the carrier tray but they are not suited for everyone so don't expect that your dentist will automatically want to use that approach.
drburkharrt Elsie, we find this disorder very frustrating for patients and practitioners. Any chronic disease states are difficult to deal with. Sometimes patients go from one person to another. That is why I say that working with all healthcare providers to give the optimal care is crucial.
ru The pictures on the web are not clear of OLP or of the body. Where can I obtain clearer pictures of OLP?
hoke what about the likely affect of olp with hcv treatment? and, is there any connection between OLP and cryoglobulinemia?
drlewis Debs. many people have OLP without knowing it. It is only when symptoms of pain occur that they seek help and are are diagnosed.
drburkharrt ru, everyone appears different. Using slides on the net is not the optimal choice for diagnosis. You need to have a clinical, pathological diagnosis.
drrees keg- your just asked the question we are all trying to answer. We know about some things that can cause a reaction similar to lichen planus. This includes drugs. We still, however, don't know what the exact cause is although we have a pretty good idea of what it is not such as an infection.
merrillgerber Dr Rees--I find that since OLP is not fatal, and that doctors tell me "no one knows the real cause, and there is no cure" that there's a sense of dismissal, "live with it"--but it's not taken very seirously. We who have it know that it affects every day of our lives, our eating, and our sense of well being.
Judy Are there any specific drugs that can cause/upset OLP?
Debs Can LP attack areas inside the body that have been injured? (looking like scar tissue?)
elsie Dr burkhart I have been e-mailin with you alot in re:to my mother can anyone interested please wirte her and give her your stories and hope?
drrees merrillgerber, you are right, that still seems to happen. As you can tell we don't believe that you just have to live with it. Contact Dr. Burkhart and we will try to find someone to refer you to in your area who may be able to help.
drburkharrt Hoke, I would feel better if you just contact us after with HCV and OLP. There are clinicians and reseachers who are conducting studies to answer these specific questions regarding your case.
drrees Judy, there is a rather long list of drugs posted on the website. Be aware however that we list them even if they have only been reported once to cause the problem. The most common drugs are non-steroidal antiinflammatory agents and medications taken for high blood pressure.
keg Ok, thanks, a went to an ENT dr and he took one look in my mouth a gave the diagno if OLP and took biop to confirm and thenn told me that nothing would help, tostop the Predision I was on, and to use a salt water rinse. predisone 20 mg did help but all drs seem to feel that it is too much medicine for the OLP unless it becomes too bad.. but it did clear things up in my mouth although it didn't help the vulva lesions.couenoooLP
elsie if it was a med reaction cause and the med was stopped then 99% chance in time that would clear correct?
merrillgerber I belong to an HMO (Kaiser) and was sent from ENT (where they knew very little about OLP) to Dermatology (where they have seen few cases, if any) What medical speciality is likely to know the most about this condition? It seems relatively rare--
drlewis Antidiabetic drugs are also a frequent cause of OLP .
drburkharrt Elsie, I am trying to place you and your mother. I have been talking with two people both of whom have mothers in their 90's. Which state are you in? Michigan or Texas?
Judy I take toprol for tachacardia, but I believe it is also prescribed for high blood pressure. It is a statin. How does that affect OLP?
elsie Michigan
Debs Can LP attack areas inside the body that have been injured?
Rosalie I take Diovan for high blood pressure and have been on medication for that for several years...this is the first I've heard that might be the cause. Would discontinuing the medication reverse the OLP? Losing the weight might help bring the bp down naturally.
keg I take Prandin but didn't start until after the OLP appeared. Is this a drug that make the OLP flare up?
drburkharrt Elsie, yes that helps. I would be happy to contact your mother. Please get with me again after the session.
elsie What about a nutriutionist when you havent been ablle to eat hardly anything in 4yrs? Good Idea?
drrees Judy, I don't have my text here but I think toprol is a beta blocker not a statin. There is one report of a non-specified beta blocker causing a lichenoid reaction but the chances are pretty slim. I doubt that it relates to your mouth condition
hoke what causes the web like lesions? I have them at the corners of my mouth kinda of extending to my lips.
drburkharrt Elsie, yes.
elsie Thank YOu Dr Burkhart!!!!!!!!!!!!!!!!
drlewis If OLP appears a few weeks after starting a new drug then it should raise a question about the likely connection.
drburkharrt Hoke, I have a great article on OLP and the lip-remind me
drrees hoke-that doesn't sound like olp. Be sure and talk with your health care provider about that.
merrillgerber Dr. Rees: is it true that it can take a long time after stopping a medication for OLP to subside--and it is worth stopping medications that work for me to try to see if they are the cause? Or just treat the OLP as best as possible?
aupton About 10 minutes to go, everyone. The docs will be logging off precisely on the hour, so if your questions/concerns are unfinished, their contact info is on the web site.
aupton The room will remain open for a few minutes after the hour for email exhanges.
hoke should i use Protopic on my lips preventatively? In other words, when there is no open lesion?
merrillgerber Dr. Burkhart--is it possible to get copies of OLP articles from you, please?
Judy When diagnosed with LP, it started on my wrists. It has settled in my mouth. If I need surgery, how will that affect the healing process? Will it flare up again on my body?
ru Are there any local support groups forming. Any in Arizona?
merrillgerber My e mail is merrillgerber@yahoo.com
elsie anyone willing to tell your story and success please help me to send info to my mother
Debs Can you have LP internally at an injury site?
Maryp in regard to articles on your sight...are those periodicals in the local library?
drrees merrillgerber- Our experience is that some patients will clear up within a few weeks after they stop the drug. Others may take several months. An example of that is gold salts that may requrie 3-5 months to be eliminated from the body. Of course your underlying medical condition gets top priority and one must also consider the availability of effective substitute drugs.\
drlewis Merrillgerber Yes, OLP can take several weeks to subside after stopping medication.
drburkharrt Anyone who needs information, can contact me after the session. We are getting many requests for educational information recently so we will get some to you when we can.
hoke Thank you all!
Maryp Yes this helps!
Rosalie Thank you, Dr. B., I really appreciate your efforts in making these discussions possible.
elsie my e-mail is williams_dent@hotmail.com, please contact me for info to send stories thank you
Debs Can Baylor add a patient to patient chat room to this site so we can communicate with each other betwenn sessions?
drrees Debs- I am not aware of internal lp in an injury site. Remember that lp affects skin and mucous membranes so the nose, throat, genitalia, anus and other areas can be affected but the incidence is much more frequent on the skin and in the mouth
hoke any chance of getting the prediction re: HCV treatment & flair of OLP?
vic Type here it certainly helps...sometimes I feel that I'm the only person who has this stuff..
drburkharrt Ru, Arizona appears to be a difficult area to find someone to refer patients who have OLP. Anyone reading this who recieves treatment, please contact me with some names. We are having an oral med. meeting there in April.
merrillgerber Appreciate your help, to all, thanks.
drrees hoke, the evidence is stronger regarding HCV itself and olp than it is for the treatment drugs
elsie Thanks All. Please contact me with your stories! Everyone!!!!!!
hoke thanks Dr. Rees.
drburkharrt Mike, thank you so much for joining us. I know that you need to go on the hour. Your information has been great!
aupton The transcripts for this session, and all the others, will be on the web site by this afternoon. About 5MIN until the doctors will need to log off.
Judy Thanks for your concern for all of us with questions. It's nice to know that we're not alone in this.
KathaB Anyone wishing to know more about the Plaquenil, contact me at <kathaB2@aol.com
drrees Thanks a lot mike. It was good of you to join us. Send us some more dental students! We enjoyed the last two.
ru Oral Surgeon..Dr. Ron Quintia in Tucson,Az.good contact
drlewis Dear All. I have really enjoyed this session. Hope to join you again sometime.
Maryp How about in RI?
drburkharrt ru, send the details of this OS.
Debs Thanks all the docs and looks forward to future information
Judy How often does OLP affect the tongue?
drlewis The tongue is the second most common site for OLP.
drburkharrt Judy, We have gotten many emails recently from patients who have olp/tongue.
drrees I would like to close by reminding everyone that it is important to know for sure that you do have oral lichen planus. Many other conditions may look very similiar so be sure and see your dentist or physician and get a solid diagnosis
Debs wonders if any docs would consider putting on state cpe class for docs and dentist that do not have adequate current information on olp
drburkharrt Debs, that is a good idea. Contact us if there is interest.
ru eye Md's also need info
drrees Debs- we do that already, but someone has to invite us. One of my colleagues is giving such a ce course right now

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drburkharrt Ru, yes. Last year I presented info to GYN's in another state.
aupton Thanks, to all our guests. It was great having you join us. The college policy will not permit the room to be left open unattended, however I will leave it open for about 5 minutes after the hour for the exchange of emails, etc. Please make all your recommendations to each other privately.
drrees Thanks to all. We appreciate you sharing your concerns. Your comments and questions help us to better provide information to our own patients.
Debs Is there any interest in a putting together a yahoo LP chat group?
drrees Nancy, Good job! I'll talk with you soon. Thank you Art for your able support.
aupton We appreciate your participation. The transcript for this session will be on the web site later today. Keep in touch, everyone. The room will lose in 2 minutes, so please sign off not.

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