Oral health in recurrent aphthous stomatitis

Background: Recurrent aphthous stomatitis (RAS) is a painful oral wound affecting 40% of the U.S. population. However, its etiology is unknown. This study investigates whether there is any association between oral health factors and RAS. Methods: Data were collected at the University of Florida from June 2006 to April 2011 through questionnaires and oral exams. Participants were controls (never had aphthae), active (with clinical aphthae), or inactive (without clinical aphthae) cases. Data included demographic information, tobacco usage and extra-oral, periodontal and dental examinations. We analyzed data stored in REDCap by using Chi-Square and Kruskal-Wallis tests in SAS v9.3. Results: We recruited 332 participants (139 controls, 51 active and 142 inactive) aged 17-66 years old (24.2 ±7.6, mean ±SD), 55% female, 63% White, and 10% Hispanic. More active cases had attrition (36%) vs. inactive case (20%) or controls (18%; p = 0.02). A higher proportion of active cases had crossbites compared to inactive cases or controls (42%, 27% and 21%, respectively; p = 0.03). Overall, there was no significant difference in the presence of enamel defects (p = 0.16). However, when comparing the distribution of defects between cases and controls, cases (62%) had more widespread lesions than controls (41%; p = 0.01). Lastly, a higher proportion of active cases had tori (59%) than inactive cases (46%) or controls (42%; p = 0.11). Conclusion: A higher proportion of active RAS participants had hard tissue anomalies (attrition, crossbites, enamel defects and tori). Further research is needed to confirm and explain these novel associations.