Oral lichen planus is a chronic immune-mediated inflammatory condition that may be encountered in primary dental care settings. It exhibits a characteristic clinical and histological presentation, with symptoms ranging from asymptomatic, to persistent active lichenoid inflammation and associated pain. Oral lichenoid lesions present with a similar clinical and histopathological appearance, but are associated with extrinsic factors, or related to other systemic medical conditions. It is important to understand how patients are managed and treated in primary care, and how to recognise those who require referral to a specialist department.