Hello John,

I saw Microgirl's post as I was browsing for information on a possible link between my oral lichen planus, the ulcers inside my mouth, and my glossitis. Brushing was painful. It seemed I could not find a toothpaste that was not painful within seconds. One day I mentioned my problem while chatting in a group of people. A experienced nurse told me with no hesitation to use this specific toothpaste. It causes me no pain at all.

This part should be very interesting. I received the results of a biopsy in my mouth today. To my utter surprise, the results were negative for oral lichen planus, even though my mouth had ulcers. The official diagnosis was "ulcer, with reactive epithelial changes". I set out to find the cause of the ulcers. The most likely culprit seemed to be my CPAP mask putting too much pressure on my face. My cheeks were squashed against my teeth, and the same kind of thing was happening with my lower lip. I have been wearing a full face CPAP mask for over a decade. The ulcers in my mouth coincided with the places where the mask presses against my face. According to the CPAP forums this is common, and there are several possible solutions offered. I have not had a chance to try them.

I theorize that many of the sufferers on this forum might have oral lichen planus AND ulcers from improper cpap use, unrelated to the oral lichen planus. Treating both conditions separately may help.

These are some of the tips I have read about:
1. Dab ulcers with Q-tips soaked in hydrogen peroxide for a night or two. This might sting. This is supposed to clean the ulcers and lower the PH. Too much acid in the mouth encouraged ulcers.
2. Use white toothpaste and don't rinse.

For CPAP users: It is all about proper fit and cleaning.
1. Consider skipping the cpap for 3 days if you can, to allow healing.
2. If you have an automatic cpap with a lowest pressure setting, reduce the low pressure on the machine if your doctor agrees. Since it is automatic, the CPAP will still set the pressure to what you need. The idea here is that you may not need air pressure higher than your current low setting. If so, the air pressure can be lowered. This allows you to to loosen the straps, reducing mask pressure on your face.
3. Start out with a new mask and cushion.
4. Clean headgear weekly and the mask daily, using Johnsons baby shampoo. Instructions can be found online. In the damp environment inside the mask, disgusting stuff grows and builds up quickly.
5. Buy a tube cleaning brush and clean the tubing once a week.
6. Replace the cushion every month

This should be an interesting experiment for me. It seems I have violated every one of these tips.

I hope you are able to use this info. We who live in pain need all the help we can get.

Davemeister