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Thyroid UK
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Feeling scared about biopsy for oral lichen planus

Morning lovely people. I have had hashis for over 20 years now, and in the last year have also developed erosive oral lichen planus.

I saw an oral surgeon last week who didn't exactly have the best bedside manner, took one look in my mouth and said "yes that's really bad, we will need to take a biopsy from both sides of your mouth". She then rattled through the list of possible risks and made me sign a form to say I consented to having it done.

Although I'm not usually a worrier and am quite used to managing my health, I have always been quite scared of the dentist and have found myself feeling really anxious about this. I know in reality it's not a big procedure, and that the list of risks she read out are extremely unlikely. I'm not really worried about what the biopsy will show, as I'm pretty sure it is lichen planus.

I'd really like to hear from anyone else who has had to have this done, and what to expect. So far I've avoided too much googling about it because there's always someone on the internet with a horror story!

Thanks in advance.

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Alison, the usual treatment for lichen planus is a hydrocortisone gel. Have you used something like this and it's not working?

Are you in the UK?

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Hi, thanks for your reply. I am in the UK and apparently will probably need a steroid mouthwash, but they won't prescribe that until I've had the biopsy. It isn't possible to get it other than on prescription thorough the NHS unfortunately so I am a bit stuck.

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There's a gel that is applied only onto the affected areas. (Can't remember the name but it may not be the same as what's available in the UK anyway. I'm in Canada.)

If you have amalgam fillings and the lesions are on the gum tissue around these teeth, you may have developed an amalgam allergy. If so, I guess doing a biopsy would make sense.

Over here usually oral pathologists are consulted for 'weird stuff'. They see lichen planus all the time so they don't do a biopsy.

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It does seem slightly over the top to me too, but my dentist, who I first saw about it, said he was no longer able to prescribe the steroid and that it's standard procedure to refer to a hospital these days. My mouth is pretty bad to be honest, but I'd rather not have bits of it cut out :-)

Oh well, I suppose I'll just have to grit my teeth and have it done.

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It is routine now. I work with the Consultants that do them. It will heal afterwards.

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Patients are referred for patch testing by dermatology and if it comes back showing allergies the fillings are replaced

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Thank you

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Hello

I had a mouth biopsy about a month ago after a year of painful problems

with my mouth. Consultant was pretty sure it was litchen planus.

I was really stressed and worried about the procedure being painful etc.

I am a really anxious person and had got myself into a real state.

It was fine and I actually didn’t feel anything at all as the injection completely numbed everything. It only took a few minutes.

It was a bit sore for about a week after but nothing bad at all. Slightly difficult

eating wise so did have lots of soups etc. Just about completely healed

now and back to eating normally etc.

I had the follow up last week and was told it hadn’t shown anything but he still was sure it was litchen planus.

I have over the last year found different things which do help ie toothpaste

gel etc. Consultant gave me some little pink pills which really did help and

cleared up the ulcers and most of the problems. The pills were for a mouth

wash and not for swallowing. These pills are only to be used when my mouth is really sore. Touch wood things are much improved.

I am sure you will be fine, it’s the worrying prior to having it done that’s the

bad bit 😉.

All the best

B

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Thank you so much for this. It's exactly what I needed to hear! I hope your mouth continues to improve and am glad you were able to get something to help.

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Just in case anyone comes across this post looking for information about what a biopsy for OLP involves, I thought I would add an update after having it today.

It wasn't too bad and I didn't feel anything. I've had biopsies taken from both sides of my inner cheek and 3 stitches in each. Even the numbing injections weren't too painful and not as bad as the ones at the dentist for a filling. My lips never went numb, which is the worst bit about the dentist's ones in my opinion! It took about 5 minutes per side and I kept my eyes closed so didn't see anything. I told the surgeon I was anxious about it and tried to persuade him to prescribe something for me without the biopsy, but he wouldn't budge.

It was very sore later that evening, although not unbearable. I cheered myself up by eating lots of rice pudding and custard (not very good for my low carb diet, but needs must!). The worst part were the stitches which I kept catching (not really painful, just made eating difficult) and they didn't fall out for 10 days.

Now I have to wait 3 months (!) for the next appointment for the results and to be prescribed anything.

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