The relationship between clinical symptoms of oral lichen planus and quality of life related to oral health

(2024) 24:556 Hashemipour et al. BMC Oral Health https://doi.org/10.1186/s12903-024-04326-2 BMC Oral Health Open Access RESEARCH The relationship between clinical symptoms of oral lichen planus and quality of life related to oral health Maryam Alsadat Hashemipour1,2*, Sahab Sheikhhoseini3, Zahra Afshari4 and Amir Reza Gandjalikhan Nassab5 Abstract Introduction Oral Lichen Planus (OLP) is a chronic and relatively common mucocutaneous disease that often affects the oral mucosa. Although, OLP is generally not life-threatening, its consequences can significantly impact the quality of life in physical, psychological, and social aspects. Therefore, the aim of this research is to investigate the relationship between clinical symptoms of OLP and oral health-related quality of life in patients using the OHIP-14 (Oral Health Impact Profile-14) questionnaire. Materials and methods This descriptive-analytical study has a cross-sectional design, with case–control comparison. In this study, 56 individuals were examined as cases, and 68 individuals were included as controls. After recording demographic characteristics and clinical features by reviewing patients’ records, the OHIP-14 questionnaire including clinical severity of lesions assessed using the Thongprasom scoring system, and pain assessed by the Visual Analog Scale (VAS) were completed. The ADD (Additive) and SC (Simple Count) methods were used for scoring, and data analysis was performed using the T-test, Mann–Whitney U test, Chi-Square, Spearman’s Correlation Coefficient, and SPSS 24. Results Nearly all patients (50 individuals, 89.3%) reported having pain, although the average pain intensity was mostly mild. This disease has affected the quality of life in 82% of the patients (46 individuals). The patient group, in comparison to the control group, significantly expressed a lower quality of life in terms of functional limitations and physical disability. There was a statistically significant positive correlation between clinical symptoms of OLP, gender, location (palate), and clinical presentation type (erosive, reticular, and bullous) of OLP lesions with OHIP-14 scores, although the number or bilaterality of lesions and patient age did not have any significant correlation with pain or OHIP scores. Conclusion It appears that certain aspects of oral health-related quality of life decrease in patients with OLP, and that of the OLP patient group is significantly lower in terms of functional limitations and physical disability compared to the control group. Additionally, there was a significant correlation between clinical symptoms of OLP and pain as well as OHIP scores. Keywords OHIP-14, Oral lichen planus, Quality of life *Correspondence: Maryam Alsadat Hashemipour Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Hashemipour et al. BMC Oral Health (2024) 24:556 Introduction Lichen planus (LP) is a chronic and relatively common mucocutaneous disease that often affects the oral mucosa. The exact cause of the disease is yet to be discovered; however existing evidence suggests the involvement of immunologic processes in the etiology of the lesions. The disease is more common in women and middle-aged people, with an estimated prevalence ranging from 1% to 2.2% [1]. In the oral mucosa, LP typically presents as white lesions, often with erosions. The most common clinical pattern is the reticular form [1–4]. The most frequently affected oral sites are the buccal mucosa and, subsequently, the tongue and gingiva. Furthermore, the reticular, erosive, and bullous clinical patterns are common [5, 6]. The prevalence of LP lesions and other epidemiological parameters reported in various studies vary significantly. One major reason for these variations is the differences in research methodologies, study populations, sampling techniques, and sample sizes. Many studies have been conducted in dental clinics and hospitals [2–4], and population-based studies are limited [5, 6]. Given that many cases of oral LP are asymptomatic, and the possibility that these studies may not encompass all cases, this issue is raised. Moreover, the presence of lichenoid lesions as a broad spectrum of lesions with similar clinical and sometimes histological features can complicate the accurate diagnosis of LP [7]. Numerous clinical indices have been developed and refined based on clinical experience for the classification of oral LP [5]. Clinical features includes size, color, and location-based distribution [5]. The common clinical signs and symptoms of oral LP range from a burning sensation to severe chronic pain [4]. The measurement of pain associated with oral LP has been widely used in clinical practice and research [8–11]. Despite the availability of pain rating scales, none are capable of comprehensive assessment of the multidimensional aspects of pain [12]. Oral lichen planus is generally not life-threatening. However, the consequences of oral lichen planus can lead to the worsening of the quality of life in physical, psychological, and social dimensions. Effects such as difficulty eating certain foods, which can lead to weight loss or malnutrition in severe cases, have been reported. Dietary satisfaction is at risk and can impact happiness and social abilities [13, 14]. Furthermore, speech problems that may result from dry mouth have also been reported [15]. Additionally, the presence of an ulcerative lesion can restrict the performance of daily oral hygiene activities [16]. In terms of sleep disturbances, patients with oral lichen planus have more sleep disorders compared to healthy individuals Page 2 of 10 [17]. It appears that sleep deprivation can amplify pain signals and increasing pain sensitivity [18]. Some studies have shown that patients with oral lichen planus experience higher levels of stress and anxiety compared to healthy individuals [19, 20]. (...truncated)