Key pointers:
Oral lichen planus (OLP) is a chronic inflammatory condition that affects the lining of the mouth.
In some cases, the inflammation may extend to the throat or upper oesophagus, causing pain or swallowing difficulty.
ENT evaluation helps confirm the extent of involvement and guide appropriate treatment.
Management focuses on reducing inflammation, preventing infection, and improving comfort.
What Is Oral Lichen Planus and How Does It Affect the Mouth?
Oral lichen planus (OLP) is a condition where the body’s immune system mistakenly attacks the cells of the mouth’s inner lining (oral mucosa). It is not infectious or cancerous, but the resulting inflammation can cause:
White, lace-like patches on the cheeks or tongue
Red, swollen, or sore areas inside the mouth
Burning or pain when eating spicy or acidic food
The condition often affects middle-aged adults and tends to be long-term, with periods of flare-up and remission.
Can Oral Lichen Planus Spread to the Throat?
Yes, in some individuals, oral lichen planus may extend beyond the mouth to the back of the throat (pharynx) or even the upper oesophagus. This can lead to discomfort, dryness, or a burning sensation when swallowing.
When the inflammation affects deeper areas, patients may describe symptoms such as:
Persistent sore throat or hoarseness
Difficulty swallowing (dysphagia)
A sensation of something stuck in the throat
Pain when eating or drinking
These symptoms can be similar to other ENT or gastro conditions, so accurate diagnosis is important.
Why Does It Hurt to Swallow If You Have Oral Lichen Planus?
Pain when swallowing occurs when inflamed tissue extends from the mouth to the throat or oesophageal lining. The inflammation can make the mucosa more fragile and sensitive to irritation from food, saliva, or stomach acid reflux.
In some cases, mild ulceration or narrowing of the affected area may develop if the condition is long-standing.
An ENT specialist may perform a nasal endoscopy or throat examination to visualise the extent of inflammation and rule out other possible causes such as infection, reflux, or growths.
How Do ENTs Diagnose Oral Lichen Planus in the Throat?
Diagnosis usually involves:
Visual examination of the mouth and throat using a scope
Biopsy of a small tissue sample for confirmation
Assessment for associated conditions, such as skin or gum lesions
Discussion of medical history, medications, and other autoimmune symptoms
Because oral lichen planus can resemble other oral or throat conditions, biopsy results are key in confirming the diagnosis and ruling out precancerous changes.
What Treatments Can Help If Oral Lichen Planus Affects the Throat?
Treatment aims to reduce inflammation, relieve pain, and prevent secondary infection. ENT specialists may recommend:
Topical corticosteroid gels or sprays to calm inflammation
Medicated mouth rinses to reduce irritation
Treatment for acid reflux, if it worsens throat symptoms
Regular monitoring to check for healing or changes in tissue appearance
Lifestyle adjustments, such as avoiding spicy foods, quitting smoking, and maintaining good oral hygiene, can also help reduce flare-ups.
When to See an ENT Specialist
You should seek ENT evaluation if:
Mouth or throat pain lasts more than two weeks.
Swallowing becomes painful or difficult.
White or red patches persist despite medication.
There is bleeding, hoarseness, or weight loss.
Early assessment helps confirm the diagnosis, exclude other causes, and guide safe management.
Takeaway
Oral lichen planus usually affects the inside of the mouth, but in some cases, it can extend to the throat and cause swallowing discomfort. Because these symptoms can overlap with other ENT or gastrointestinal conditions, professional evaluation is important. ENT specialists can diagnose the extent of involvement, recommend treatment to control inflammation, and help maintain comfort and function.
Get Personalised ENT Care for the Whole Family
Suppose you experience persistent mouth or throat pain. In that case, Dr Soon Sue Rene at Adult & Child ENT Specialists provides comprehensive assessment and care for oral, nasal, and throat conditions in both adults and children. Schedule a consultation to discuss your symptoms and explore suitable treatment options.
Frequently Asked Questions
1. Can oral lichen planus turn into cancer? Most cases do not become cancerous, but long-standing inflammation in certain forms (especially erosive or ulcerative types) may increase risk. Regular ENT or dental follow-up helps detect any early changes.
2. Is oral lichen planus contagious? No. It is an autoimmune condition, not an infection, and cannot be passed from person to person.
3. Can oral lichen planus cause swallowing pain even if my mouth looks fine? Yes. The inflammation can extend deeper into the throat or oesophagus, even when mouth lesions are mild or healing. Persistent swallowing discomfort should be checked by an ENT specialist.
4. How long does oral lichen planus last? It is typically a chronic condition that may come and go over months or years. Treatment helps control symptoms and reduce flare-ups.
5. Are there foods I should avoid with oral lichen planus? Yes. Spicy, acidic, or rough-textured foods can worsen irritation. Limiting alcohol, caffeine, and tobacco can also help reduce inflammation and promote healing.
