1545 Patient-reported risk factors for recurrent aphthous stomatitis (RAS)

Saturday, March 24, 2012: 9:45 a.m. - 11 a.m.
Presentation Type: Poster Session
G. SERRANO1, R. LALLA2, J.J. SHUSTER3, D.W. THERIAQUE4, and L. BACCAGLINI1, 1Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, 2Section of Oral Medicine, University of Connecticut Health Center, University of Connecticut, Farmington, CT, 3Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, 4Regulatory Knowledge and Research Support, Clinical & Translational Science Institute, University of Florida, Gainesville, FL

Recurrent aphthous stomatitis (RAS) is a painful ulcerative disease of the oral mucosa affecting 40% of the US population for more than 20 years in a lifetime. The etiology of RAS remains unclear. In an attempt to identify risk factors for RAS, we investigated changes in a number of patient-reported variables in the 48 hours immediately prior to the onset of RAS episodes.


Data were collected during a case-control study at the University of Florida from June 2009 to April 2011 through standardized questionnaires and oral examinations. Controls never had RAS and cases (>2 idiopathic RAS ≤6 months ago) were ‘active’ (with clinical aphthae), or ‘inactive’ (no aphthae in ≤5 days). Main eligibility criteria were: age >12 years, fasting for >5 hours, no tobacco, alcohol or medications affecting the immune system within 24 hours prior to the visits. Participants reported changes in their mouth, appetite, stress, sleep, health, body pain, diet, exercise, ability to concentrate and phone use (used as negative control variable) in the 48 hours prior to a visit (or before RAS onset, if active cases), compared to the previous week.  Data stored in REDCap were analyzed using Fisher’s exact test or Cochran-Mantel-Haenszel test with modified ridit scores in SAS v9.2.


Data were available for 108 participants (48 controls, 30 active, and 30 inactive). Participants were 18-50 years old (23±5; mean±SD), 51% females, 64% White, and 19% Hispanic. More active cases (40%) reported increased mental stress levels vs. inactive cases (17%; p=0.048) or controls (15%; p=0.025). There were no significant changes for other variables.


These results support an association between increased mental stress and the onset of RAS episodes and suggest that the other patient-reported variables we examined are not significant contributors or co-factors in the pathogenesis of RAS.

This abstract is based on research that was funded entirely or partially by an outside source: Supported by the National Institutes of Health (NIH), National Institute of Dental and Craniofacial Research (NIDCR) grants R21DE018714 and R03DE016356 and National Center for Research Resources (NCRR) CTSA grants M011RR000082 and UL1RR029890

Keywords: Oral medicine and aphthous stomatitis
See more of: Mucosal disease
See more of: Oral Medicine & Pathology