Lichen planus, like its cousin psoriasis, can be triggered by trauma or irritation. Therefore, the wear and tear of getting the dental work performed may have been a trigger for the formation of lichen planus. Some years back, there was a flurry of case reports looking at the potential role of amalgam in oral lesions. Currently, the consensus is there is no association between the amalgam composition and lichen planus. So, I would not recommend that your patient go through the expensive process of changing out all of their fillings. In fact, this may aggravate the oral lichen planus.

Treating oral lichen planus is dependent upon the degree of severity. Mild oral LP with no symptoms doesn’t require any treatment. Oral LP that is symptomatic, but localized to small regions of the oral cavity can be treated locally, either by application of potent topical corticosteroid ointment on a small gauze pad, or intralesional injection of triamcinolone. More severe oral LP will require systemic therapy for proper control. This could include oral corticosteroids, or other non-steroidal immunomodulators like azathioprine. The condition is chronic and prone to periods of worsening and improvement. Ultimately the condition clears, so treatment is aimed at controlling symptoms.

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