Oral Lichen Planus and Relapse

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LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Oral Lichen Planus and Relapse

#1 Post by LockedinMyTower »

Hi, my name's Gina. I registered to get some feedback and to see if anyone else has dealt with what I'm currently dealing with now. (My search results only found one person and the thread was old!)

I'm 24 years old, first off. I had two sets of metal braces when I was super young, along with a palate expander. By 2003, I was done and religiously wore my upper and lower Hawley retainer every night. I was dealing with chronic health issues at the time, but nothing that effected my mouth.

Until 2012, I started having cheek peeling, tongue burning, you name it, I had it. It all seemed to start when I was sick right after Christmaa 2011. To go back a bit further, I've been dealing with vulvar lichen planus since 2004. It normally starts in your mouth, which is a mucus membrane, FIRST, but I ended up having it the other way around. Anyway, my primary dentist sees my mouth and says lichen planus. I go to an oral surgeon who says the same, but orders a biopsy to be sure. Like the six vulvar biopsies I've had, this one came back as nothing more than "inflammation." It was an absolute nightmare. I end up, by contact of my vulvar specialist, end up seeing another oral surgeon in Boston who prescribes two medicated mouth rinses. When I tell him I use a retainer (I had stopped using it when my symptoms started), he told me to discontinue it.

Time goes by.

My OLP gets somewhat better. I change my toothpaste, educate myself, even though there isn't much out there, use my medicated mouth rinses, figure out my irritants, and thus OLP starts controlling my life...and my teeth slowly, but surely, start to shift.

After dealing with other health woes, I'm now in the process of getting my teeth realigned. My bottom and top retainers now longer fit, so I first had my original orthodontist make me a bottom spring retainer to push out one tooth that is out of place. I wanted to see if my lichen planus would react to something foreign in my mouth, but knock on wood, so far, so good.

Now, my top is another story. It seems like my teeth, or my palate has somewhat narrowed. My biggest concern is my bite, which is off only on one side, according to my orthodontist. My teeth are still straight in front, but has pushed out because of my palate narrowing. It seems like my orthodontist must've looked OLP up, and first says metal braces on the top, and when I went for an adjustment on my bottom retainer, mentioned a retainer for the top as well. I'm not sure where it's going to go from here, and I feel silly for even saying this, but I've shed many tears over this. I'm beyond thankful it's a situation where money isn't an issue, but I'm beyond frustrated that four years could cause this much damage, after almost ten years of retainer wear. (And I'm sure people say they wear their retainers all the time and lie, but hand on Bible, I did wear mine!) I think on top of it all, the shifting has caused an open bite that I didn't even realize I had until I started going through old photos.

In my head, a removable top and bottom would be the ideal situation, but I don't know how much a retainer could do to fix my issues. I don't know if my OLP would flip out with metal brackets in my mouth 24/7, but I'll do what I have to do.

Anyway, that's my story, reaching out for any words of wisdom. If anyone has any thoughts, or if they're dealing with oral lichen planus, please let me know! Thanks, Gina

sirwired
Posts: 2104
Joined: Thu Oct 30, 2008 10:05 am

Re: Oral Lichen Planus and Relapse

#2 Post by sirwired »

Well, it appeared that removing the retainer didn't help the OLP, so certainly getting new ones fitted while you figure out what to do next is a good start. (Personally, I'd be peeved at the OMFS that told you to stop wearing it without trying to come up with an alternative; it was there for a reason.)

In any case, I wonder if treatment could consist of a palatal expander (which is pretty close to a Hawley anyway) followed by a TPA (to prop the palate open) and aligner trays (to avoid brackets, if brackets are something that irritates your OLP.)

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#3 Post by LockedinMyTower »

[quote="sirwired"]Well, it appeared that removing the retainer didn't help the OLP, so certainly getting new ones fitted while you figure out what to do next is a good start. (Personally, I'd be peeved at the OMFS that told you to stop wearing it without trying to come up with an alternative; it was there for a reason.)

In any case, I wonder if treatment could consist of a palatal expander (which is pretty close to a Hawley anyway) followed by a TPA (to prop the palate open) and aligner trays (to avoid brackets, if brackets are something that irritates your OLP.)[/quote]

First off, thanks for replying! I've done some research already. From dealing with my overall bad health, a part of me feels like I do a lot of the work doctors are supposed to be doing on my behalf! Haha! I like going in knowing kind of what I'm talking about, so the fact that you were kind enough to lay out what *could* happen lessens my anxiety. I realize you're not a professional, but thanks regardless!

I'm definitely not happy about what the oral surgeon told me to do, but I figured at the time, I was in so much pain, I was willing to do anything. I wasn't even sure if the retainer was making things worse, but by that point, I hadn't been wearing it for maybe four/five months and my symptoms had stayed the same. Another part of me was afraid to put it in once I had everything semi-under control. I'm still upset, honestly, but I'm trying to look towards the future. I'm shocked this little time had gone by with so much movement.

I wouldn't wish OLP on my worst enemy. Apparently, ther are different levels of severity and of course, mine is the worst. I've been able to control it, but without the medications, I had and sometimes still have days where I can't speak. I've had more pain with lichen planus than I ever did through my whole orthodontic treatment!

What's a TPA? I'll Google it, I'm just curious if you've had experience with it yourself.

My orthodontist didn't think clear aligners would work, but I plan to ask him about it once I get the bottom situated. (The only thing on the entire Internet I could find pertaining to orthodontics and OLP was someone claiming Invisalign was making their active OLP worse. Something about the plastic?) The bottom retainer seems to be doing its job pretty well, which gives me hope for the top! I'm not worried about how I'd look with braces again, my big concern is I don't want to rock the boat with the OLP.

sirwired
Posts: 2104
Joined: Thu Oct 30, 2008 10:05 am

Re: Oral Lichen Planus and Relapse

#4 Post by sirwired »

A TPA is a "trans-palatal arch". It's simply a wire that runs across the roof of your mouth and attaches to an inner bracket on each side. I had one after jaw surgery to "prop" my palate open until I was done with braces and could be fitted with a Hawley. There are multiple types; some have springs in them (I guess if they are supposed to perform some movement.) It's kind of annoying, but if your LPA is affecting your tongue, may not be an option.

If the OMFS/Ortho thinks aligners will irritate things, then I'm not going to contradict that (obviously!) Certainly a TPA can be used with brackets also.

If you live near a dental school with an ortho program, you might want to contact the "Faculty Practice" and see if they have a professor that could be of assistance; they have the advantage that if the school ALSO has an OMFS program, they can collaborate to figure out the best course of action. (My jaw surgery plan was put together through such a collaboration, although my ortho was private-practice.)

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#5 Post by LockedinMyTower »

[quote="sirwired"]A TPA is a "trans-palatal arch". It's simply a wire that runs across the roof of your mouth and attaches to an inner bracket on each side. I had one after jaw surgery to "prop" my palate open until I was done with braces and could be fitted with a Hawley. There are multiple types; some have springs in them (I guess if they are supposed to perform some movement.) It's kind of annoying, but if your LPA is affecting your tongue, may not be an option.

If the OMFS/Ortho thinks aligners will irritate things, then I'm not going to contradict that (obviously!) Certainly a TPA can be used with brackets also.

If you live near a dental school with an ortho program, you might want to contact the "Faculty Practice" and see if they have a professor that could be of assistance; they have the advantage that if the school ALSO has an OMFS program, they can collaborate to figure out the best course of action. (My jaw surgery plan was put together through such a collaboration, although my ortho was private-practice.)[/quote]

That's an excellent idea about looking into a school with an ortho program! It seems like everyone in the medical community acts like oral lichen planus is no big deal, but have zero idea how to treat it. Guess it's not that common! I'm thinking probably out in the Boston area I'd have the best luck. I don't live in the sticks, but it's more rural.

The idea of jaw surgery sounds terrifying. Are you happy you went through with it, looking back?

I went in today to have my bottom retainer adjusted, and he was happy things have moved. He was more happy, I think, that the OLP hasn't been irritated by it. He adjusted it, and said some of my bottom teeth had moved more than the one we were trying to fix, but didn't seem concerned. I've noticed a change myself, and it's only been about three weeks. I go back on Halloween for another adjustment. Then, I plan on asking about what he thinks about the top.

I feel old, though! I went in and the office was decorated with music, music notes and all the like and there's a One Direction poster hanging on the wall! He does adult orthodontics as well, but I think his practice is mostly kids--I was ten, eleven when I first started seeing him. Either way, damn, I'm out of touch! Haha!

Yeah, I Googled the TPA appliance. I have no idea how my mouth would react to something cemented in permanently and of how my tongue would react. (The idea of lingual braces intrigued me, too, but they look harder to clean and I've read about people complaining about tongue cuts and pain. I have enough of that on my own!) I've had to juggle using my medicated mouth rinses and the bottom retainer as it is. My mouth acts up if I don't use my oral medication within 24 hours, so I've been wearing the retainer between meals (rinsing with a Water Pik afterwards) and every other night. It's not ideal, I wish I could wear it more, but I'm being as consistent as possible! I'm happy I've had any movement, to be honest.

Like I said, if I could do something removable on the top, I'd be thrilled, like an expander and then something else to bring my teeth back in. Even if it took longer treatment wise, I'd have control when the lichen planus acts up and it always does. It waxes and wanes. Sometimes for reasons I can explain, sometimes it makes no sense why my mouth is bothering me!

sirwired
Posts: 2104
Joined: Thu Oct 30, 2008 10:05 am

Re: Oral Lichen Planus and Relapse

#6 Post by sirwired »

I'm happy with how my jaw surgery turned out. My presenting problem was 0% cosmetic (I was quite satisfied with my smile); instead I was experiencing severe gum recession due to a mis-aligned bite. The surgery itself was not fun, and recovery less so, but I'd do it again.

BTW, Boston U has a dental school with both an Ortho and OMFS program (and oral pathology is a common OMFS sub-specialty), so they might be a good place to consult if your local ortho can't resolve things to your satisfaction.

PinkPeep
Posts: 26
Joined: Tue Sep 29, 2009 9:28 am

Re: Oral Lichen Planus and Relapse

#7 Post by PinkPeep »

Hi Gina,
I am sorry to hear you are going through this and I hope it clears up for you. I have OLP as well and it is a frustrating condition. I had octagon shaped purplish lesions suddenly appear on my ankles and wrists around January 2013. I thought I was getting bitten by bugs or something. Later that year, at my biannual dental cleaning, the dentist noted the classic lacy lesions on my cheeks and tongue and tentatively diagnosed OLP. When I went to research it online, I saw photos of skin lichen planus and it perfectly matched the lesions on my ankles and wrists. At my oral biopsy, I showed the dentist my arms. Between that and the biopsy results, the diagnosis was made. It cleared on my ankles and wrists without treatment after about 6 months, but the OLP has continued to worsen and become erosive. I am currently in Invisalign and I was worried that it might make it worse, but there has been no difference. Hang in there.

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#8 Post by LockedinMyTower »

[quote="PinkPeep"]Hi Gina,
I am sorry to hear you are going through this and I hope it clears up for you. I have OLP as well and it is a frustrating condition. I had octagon shaped purplish lesions suddenly appear on my ankles and wrists around January 2013. I thought I was getting bitten by bugs or something. Later that year, at my biannual dental cleaning, the dentist noted the classic lacy lesions on my cheeks and tongue and tentatively diagnosed OLP. When I went to research it online, I saw photos of skin lichen planus and it perfectly matched the lesions on my ankles and wrists. At my oral biopsy, I showed the dentist my arms. Between that and the biopsy results, the diagnosis was made. It cleared on my ankles and wrists without treatment after about 6 months, but the OLP has continued to worsen and become erosive. I am currently in Invisalign and I was worried that it might make it worse, but there has been no difference. Hang in there.[/quote]

Thank you SO SO MUCH for replying to my thread! I'm beyond sad that you're dealing with what I am, but I'm also thrilled I reached into the void that is the Internet and you were kind enough to reply.

My tongue biopsy came back as "inflammation," as did all six (taken at different times) of my vulvar ones. My diagnosis was based on looks only and really, I did a lot of deep web searching for anything I could do to make the pain go away. Every doctor I saw was 0% helpful in dealing with ulcers and overall pain.

Have you changed your toothpaste since your diagnosis? I was using Crest forever and did a lot of homework into toothpaste ingredients. I must've spent $150 on natural toothpaste until I finally hit on a winner: Squigle Enamel Saver. It took a week or so of slowly mixing it into my then current paste for me not to have a reaction, but its something I couldn't live without now. It tastes like mild candy canes. All you really need to look for is something without any type of sodium lauryl sulfate. SLS makes the bubbles, but it can also cause ulcers. I definitely do not have as many sores as I did even prior to being diagnosised.

I'm sorry to hear your OLP is getting worse. Have any doctors prescribed any oral rinses? I currently use a variation of "Magic Mouthwash" minus the tetracycline, which causes tooth staining. It has diphenhydramine (Benadryl), hydrocortisone and nystatin, made at a compounding pharmacy. That has made a world of difference. That and MuGard, it heals mouth ulcers within 12 hours. I wish I was kidding with how effective MuGard is, but I can put a dab of MuGard with a Q-tip in the AM on a sore, 12 hours later the bump has practically vanished. It's also $450 a bottle, but the company offers financial assistance. I was paying $40 every refill, which was two bottles, but since the patent changed hands, I don't pay anything. I'm forever grateful for it. It hasn't been clinically proven to treat OLP, but "oral mucositis" which I think is oral disturbance. See if you can get your hands on a script for either or both. I'd be miserable 24/7 without them.

How long are you going to be in Invalisgn for? Is this your first trek into braces or are you dealing with this a second time around, like myself? I'm really scared of going the brackets route this time around. I did it once and it wasn't great, but now I have OLP to contend with. A spring Hawley is one thing, with fixed braces you're dealing with brackets, glue, elastics, wires, etc. I obviously want to fix what has shifted pertaining to my bite, but to me there has to be a better way. (I'm a Googler, I have been since 2004!)

Again, thanks for a reply. It sucks we're in the same boat!

PinkPeep
Posts: 26
Joined: Tue Sep 29, 2009 9:28 am

Re: Oral Lichen Planus and Relapse

#9 Post by PinkPeep »

Thank you for replying to me as well! My dentist prescribed SLS free toothpaste by colgate and an extra soft post surgical toothbrush. These have helped a lot, but they do not clean my teeth very well. A few times a week, I resort to a regular soft toothbrush and regular toothpaste, to get my teeth cleaner. It is painful :( My dentist is very holistic and works very hard to help me treat the condition without using steroids. He feels that they are more harmful then beneficial. I also see a periodontist (bone graft and implant) He prescribed me a topical steroid gel to use. My dentist was not really happy about it. I try not to use it too often, and only on bad lesions. Thank you for the recommendation for Magic Mouthwash, I will try to locate this product! I will look into the MuGard as well. This condition appeared about a month after a severe upper respiratory infection which needed antibiotics. I have long suspected that it is the result of some sort of microbial overgrowth that occurred due to the antibiotics I used to treat the infection. I have experimented with different probiotics and it has improved to a degree, but 2 spots in particular remain inflamed and irritated constantly.
This is my second round of braces. I had metal braces 20+ years ago and didnt have good retention. My bite is the biggest issue for me as well. My deep bite that was corrected years ago had relapsed and my teeth were spacing out. I have been in the invisalign for just under a year, and have about 6 months of aligners left.I am actually pretty impressed with the invisalign so far as I think it has improved the appearance of my smile. I don't feel like it has had much of an impact on my deep bite, however, and I am concerned about this considering the amount of money I have spent on all this dental work.I posted photos of my current results in the invisalign forum if you want to take a look. :D Going through a second round of braces does suck, but just keep your eye on the prize! It will be worth all the trouble!

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#10 Post by LockedinMyTower »

[quote="PinkPeep"]Thank you for replying to me as well! My dentist prescribed SLS free toothpaste by colgate and an extra soft post surgical toothbrush. These have helped a lot, but they do not clean my teeth very well. A few times a week, I resort to a regular soft toothbrush and regular toothpaste, to get my teeth cleaner. It is painful :( My dentist is very holistic and works very hard to help me treat the condition without using steroids. He feels that they are more harmful then beneficial. I also see a periodontist (bone graft and implant) He prescribed me a topical steroid gel to use. My dentist was not really happy about it. I try not to use it too often, and only on bad lesions. Thank you for the recommendation for Magic Mouthwash, I will try to locate this product! I will look into the MuGard as well. This condition appeared about a month after a severe upper respiratory infection which needed antibiotics. I have long suspected that it is the result of some sort of microbial overgrowth that occurred due to the antibiotics I used to treat the infection. I have experimented with different probiotics and it has improved to a degree, but 2 spots in particular remain inflamed and irritated constantly.
This is my second round of braces. I had metal braces 20+ years ago and didnt have good retention. My bite is the biggest issue for me as well. My deep bite that was corrected years ago had relapsed and my teeth were spacing out. I have been in the invisalign for just under a year, and have about 6 months of aligners left.I am actually pretty impressed with the invisalign so far as I think it has improved the appearance of my smile. I don't feel like it has had much of an impact on my deep bite, however, and I am concerned about this considering the amount of money I have spent on all this dental work.I posted photos of my current results in the invisalign forum if you want to take a look. :D Going through a second round of braces does suck, but just keep your eye on the prize! It will be worth all the trouble![/quote]

I've had really good luck with a Water Pik, too. It took some getting used, but my gums weren't in great shape when I was first diagnosed. I was able to start on a low setting on the Water Pik and gradually increase. I love it, though. I've stayed away from Colgate or basically anything made by Proctor and Gamble, as I've found those irritate my mouth more. Obviously, I'm not a specialist, that's been my experience! Without the SLS, you won't get that sudsing you'd get with regular toothpaste, but I was told by my dentist it doesn't really matter what you brush with, as long as technique is right and you actually brush.

Where do you live, if you don't mind my asking? I'm in Massachusetts.

I use a soft toothbrush, too, but I use a brush from GUM Sunstar called "Deep Clean Technique." It comes in a soft, compact head. You definitely want to use a soft head toothbrush, but one brand's soft is different from another.I replace it more often, but it does a great job of stimulating gums. I used to use a brush from Crest, I think, but it was discontinued. I usually buy direct from the GUM site, I can't seem to find that particular brush in stores.

I see a regular dentist, and an oral surgeon who I communicate with by e-mail. I have cleanings done with a professional Water Pik and have the hygenist numb my mouth. You won't believe it, but my previous hygenist cut my gum twice and gave me a raging infection both times--and the dentist claimed I needed to floss better. (I floss religiously!) I was so angry, I changed hygienists. I know my mouth!

It's funny you mention being sick and then being on antibiotics--I caught a really bad bug back in 2012 and the OLP started. I have a theory all of this started with the mandatory chicken pox vaccine I got back in 2004 to get into middle school. Within six months, the vulvar lichen planus and my Hell began. I can't get any professional to agree, but I find it odd that chicken pox, shingles and lichen planus are all related to each other. Food for thought!

I've usrd steroid creams for at least a decade, and I've had success with it. Nothing comes without risk, though. It may help you, it may not. The Magic Mouthwash has hydrocortisone in it, which I'm pretty sure is a steroid, but don't quote me. If you have sores that aren't healing, the Magic Mouthwash, especially the MuGard may help in finally clearing them up. The MuGard acts as a barrier to give your skin a chance to heal, if that makes sense. Your periodontist may not have heard of it, but the MuGard site has a form, or at least it did, that you could print out and your doctor could fill it out to get the script filled. It's shipped directly to you from the company, you can't get it filled at a pharmacy.

I'll definitely go take a look at your Invisalign post! I'm happy you're seeing results, because I feel like I'm in the same boat regarding retention. I don't know how I'd do with Invisalign, but I'm honestly thrilled the Hawley retainer isn't bothering things too much. It's really a question of balance for me, keeping the lichen planus at bay and getting my bite back into alignment. Very frustrated that I didn't go back and just stick the retainers in, but I needed my mouth to stop peeling at the time!

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#11 Post by LockedinMyTower »

Oh, before I forget to ask, do you have any digestion problems? I've had acid reflux since the age of 10. I was under the impression lichen planus usually appeared in the mucus membranes, so your mouth, your genitals, etc, so I'm surprised it came out on your ankles and wrists first. I would've thought the same as you, bug bites or even an allergic reaction.

And do you have any dietary restrictions? If I eat anything with spices or preservatives, my mouth acts up like crazy. It burns! And do you have any vision issues, since your eyes are also a mucus membrane?

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#12 Post by LockedinMyTower »

Just thought I'd give a quick update!

I've went in for two adjustments since my last post in October and my bottom teeth are straightening out pretty well. Definitely progress! I've been able to up the ante of wearing the bottom retainer, from eight to ten to twelve hours a day, usually when I'm sleeping. I've been using the bottom retainer with my two medicated mouth rinses. The only times I haven't been able to wear it at all were the few times my oral lichen planus flared up, including when I had my six month cleaning. For some reason, I had a pretty bad reaction to the topical numbing agent that the hygienist always uses. Go figure!

Went in for another adjustment today, he was happy with the progress! Since I know now I can tolerate the retainer, I want to get started on the top. (My Dad just got a job out of the area, and I'd like to get this done before anything permanent happens.) He's going to make me a removable palate expander to widen my upper jaw. I was told it won't affect my front teeth, as there will be a wire holding them in place. He definitely understands that I need something removable, so I'm happy about that. HE GETS IT. He said this appliance would widen my upper jaw and bring in my front teeth, but it wouldn't close my anterior open bite. He suggested Invisalign, as he didn't think an appliance would help close my bite, but even with that he wasn't sure how much it could close with Invisalign alone. Traditional braces I just cannot do. My teeth cleaning in October confirmed any doubts I had, because I was in terrible pain for four days where I couldn't wear the bottom retainer. I was beyond grateful I could take it out!

Anyway, I've seen some appliances, not the one he's making now, different ones, that supposedly can close an open bite. I plan to ask him about that when I go to pick up the upper appliance in about three weeks. Anyone use a bionator, bimler or twin block appliance for anterior open bite? Just curious if there's another way to get around this problem. Thanks in advance!

Smb06
Posts: 1
Joined: Thu Jun 15, 2017 7:54 pm

Re: Oral Lichen Planus and Relapse

#13 Post by Smb06 »

I have a trans palatal arch in my mouth, one side of the wire is cutting deep into the roof of my mouth. The roof of my mouth is swollen and bruised. Any tips?

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#14 Post by LockedinMyTower »

Smb06 wrote:I have a trans palatal arch in my mouth, one side of the wire is cutting deep into the roof of my mouth. The roof of my mouth is swollen and bruised. Any tips?
I don't have any experience with transpalatal arches, I'm sorry to say. The best thing I could offer is going back to the orthodontist and seeing what he/she can do.

LockedinMyTower
Posts: 17
Joined: Mon Sep 19, 2016 12:40 am

Re: Oral Lichen Planus and Relapse

#15 Post by LockedinMyTower »

So, UPDATE:

My bottom teeth are now pretty much perfectly straight! I'm still wearing the bottom retainer, but now the orthodontist says I only have to wear it at night. My oral lichen planus has been up and down, flare ups and pain wise, which is nothing new when dealing with OLP. I went ahead and had the top removable expander made, as I talked about in my last update, and have been expanding once a week. The orthodontist wanted me to up the ante and expand twice a week, which I've been doing on and off, depending on how the OLP is faring. Some weeks I can, some weeks I can't. The progress has been steady, but there are moderate amounts of pain. My left side is almost perfectly aligned, but my right has a little ways to go. When I asked what his thoughts were should my left side be expanded too much, he explained it already was slightly, and could take off the arcyclic on that side to allow my teeth to come back in.

I've had some cutting on the roof of my mouth after expansion. The orthodontist had to file down both the left, then the right sides a few weeks apart because of the pain it was causing. I ended up with huge ulcers both times that took a good two weeks to heal, even with my medicated mouthrinses. I lost some time with that. I wasn't surprised, but I think he was when he looked in my mouth and saw the damage.

I am finding my open bite, while still seriously prominent, has come in. The top appliance has brought my front teeth, that were jutting out due to the space loss in my upper palate, back in. I've noticed it, but my Mom actually noticed it before I did. :lol: :lol: :lol: My two front teeth separate a little bit when I expand each time, even with the wire holding them in place, but come back together within a few hours of the appliance being out of my mouth. It stresses me out each time, even though I know that's normal! :D

I wear it as much as I can, and when I can't, I try not to beat myself up over it. I go in for rechecks every four weeks, and I'm due back either next week or the week after. I've been fighting off some kind of virus the past few weeks, so unfortunately, expanding hasn't been happening as consistently as I would've liked. With OLP, my immune system is basically useless, so when I catch something, it takes me a long time to bounce back. And I catch everything, even though I'm not out with the general public. I may change the appointment until the end of the month, since not a lot of progress has been made, but so far, so good. :heart:

We did talk about possibly having to have another upper appliance made, since the orthodontist wasn't sure if I'd get all the expansion I needed before the inside mechanism ran out of room. I'm not sure if that'll happen or not yet, but we'll see!

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