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Recurrent Aphthous Stomatitis and Related Factors in Turkish Adult Population: A Striking Outcome of Cappadocia Chronic Diseases Epidemiological Study

Year 2022, Volume 44, Issue 3, 233 - 238, 01.10.2022
https://doi.org/10.7197/cmj.1081601

Abstract

Background: Recurrent aphthous stomatitis (RAS) is a common painful lesion affecting millions of people. This population-based epidemiological study aimed to determine the frequency of recurrent aphthous stomatitis in the population and associated diseases and factors.
Methods: In 2013, by the Turkish Society of Internal Medicine, a cohort for chronic diseases and related risk factors was initiated in the Central Anatolia Region of Turkey (Cappadocia region). 90% of the whole adult population was included and photos of oral aphthae were used during the questionnaire for chronic diseases.
Results: 10 992 participants, aged ≥18 years included. The mean age were 44.6± 16.4 years; 56.1% were males. RAS history was present in 13.2%, more frequent in females (17.1%). Female gender ( OR: 1.441, CI: 1.253-1.656, p<0.001), presence of any rheumatic disease (OR: 2.364, CI: 1.408-3.968, p:0.001), history of joint swelling (OR: 1.755, CI: 1.527-2.016, p<0.001), low back pain history (OR: 1.727, CI:1.529-1.952, p<0.001) were independent risk factors for RAS. Age (OR: 0.994, CI: 0.990-0.997, p:0.001), alcohol usage (OR: 0.744, CI: 0.566-0.977, p: 0.033) and smoking (OR: 0.651, CI: 0.555-0.763, p<0.001) were protective for RAS.
Conclusions: RAS prevalence was 13.2% in our population-based cohort. Underlying inflammatory rheumatic diseases must be searched in the case of RAS. Alcohol may have a reducing effect on RAS, needs further evaluation.

References

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  • Reference2 Scully C. Aphthous Ulceration. NEJM 2016; 355(2): 165-72.
  • Reference3 Rivera-Hidalgo F, Shulman JD, Beach MM. The association of tobacco and other factors with recurrent aphthous stomatitis in an US adult population. Oral Dis 2004; 10: 335-45.
  • Reference4 Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Dent Assoc 2004; 135: 1279-86.
  • Reference5 Crivelli MR, Aguas S, Adler I, Quarracino C, Bazerque P. Influence of socioeconomic status on oral mucosa lesion prevalence in school children. Community Dent Oral Epidemiol 1998; 16: 58-60.
  • Reference6 Porter SR, Kingsmill V, Scully C. Audit of diagnosis and investigations in patients with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1993; 76: 449-52.
  • Reference7 Field EA, Rotter E, Speechley JA, Tyldesley WR. Clinical and haematological assessment of children with recurrent aphthous ulceration. Br Dent J 1987; 163: 19-22.
  • Reference8 Piskin S, Sayan C, Durukan N, Senol M. Serum iron, ferritin, folic acid, and vitamin B12 levels in recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol 2002; 16: 66-67.
  • Reference9 Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992; 51: 14-16.
  • Reference10 Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioğu E, Güler K, Kiraz S, Özbakkaloğlu M, Özer B, Tükek T, Durusu Tanrıöver M, Akyar E, Çağatay P, Erdem Y.. Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. Turk J Public Health 2016; 16(3): 190-03.
  • Reference11 Rivera C. Essentials of recurrent aphthous stomatitis. Biomed Rep 2019; 11(2): 47–50.
  • Reference12 Neville BW, Damm DD, Allen CM, Chi A. Oral and maxillofacial pathology. 4th ed. Philadelphia, Elsevier, 2016.
  • Reference13 Davatchi F, Tehrani-Banihashemi A, Jamshidi AR, Chams-Davatchi C, Gholami J, Moradi M, Akhlaghi M, Foroozanfar MH, Barghamdi M, Noorolahzadeh E, Samadi F, Hadj-Aliloo M, Ghaznavi K, Ghaznavi K, Soroosh M, Khabazi A, Salari AH, Sharif SK, Karimifar M, Salessi M, Essalat-Manesh K, Nadji A, Shahram F. The prevalence of oral aphthosis in a normal population in Iran: a WHO-ILAR COPCORD study. Arch Iran Med 2008; 11: 207-9.
  • Reference14 Safadi RA. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009; 9: 31. 15 Patil S, Reddy SN, Maheshwari S, Khandelwal S, Shruthi D, Doni B. Prevalence of recurrent aphthous ulceration in the Indian Population. J Clin Exp Dent 2014; 6: e36-e40.
  • Reference16 Ciçek Y, Canakçi V, Ozgöz M, Ertas U, Canakçi E. Prevalence and handedness correlates of recurrent aphthous stomatitis in the Turkish population. J Public Health Dent 2004; 64: 151–6.
  • Reference17 Özeç I, Taşveren S, Yeler D, Kılıç E. Evaluation of Prevalence of Oral Mucosa Lesions in Individuals Over 40 Years of Age in Sivas. Cumhuriyet Üniversitesi Diş Hekimliği Fakültesi Dergisi 2008; 11: 10–5.
  • Reference18 Baş Y, Seçkin HY, Kalkan G, Takcı Z, Önder Y, Çıtıl R, Demir S, Şahin Ş. Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey. Balkan Med J 2016 Jul; 33(4): 390-5.
  • Reference19 Shah K, Guarderas J, Krishnaswamy G. Aphthous stomatitis. Annals of Allergy, Asthma & Immunology 2016; 117(4): 341-3.
  • Reference20 Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2014; 62: 205e15.
  • Reference21 Saikaly SK, Saikaly TS, Saikaly LE. Recurrent aphthous ulceration: a review of potential causes and novel treatments. J of Dermatol Treat 2018; 29(6): 542-52.
  • Reference22 Wang H, He F, Xu C, Fang C, Peng J. Clinical analysis for oral mucosal disease in 21 972 cases. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018; 43:779-83.
  • Reference23 Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am 201; 58: 281-97.
  • Reference24 Chavan M, Jain H, Diwan N, Khedkar S, Shete A, Durkar S. Recurrent aphthous stomatitis: A review. J Oral Pathol Med 2012; 41: 577-83.
  • Reference25 International Study Group for Behçet's Disease. Criteria for diagnosis of Behçet's disease. Lancet 1990; 335: 1078.
  • Reference26 Livneh A, Zaks N, Katz J, Langevitz P, Shemer J, Pras M. Increased prevalence of joint manifestations in patients with recurrent aphthous stomatitis (RAS). Clin Exp Rheumatol 1996; 14(4): 407-12.
  • Reference27 Ślebioda Z, Dorocka-Bobkowska B. Systemic and environmental risk factors for recurrent aphthous stomatitis in a Polish cohort of patients. Adv Dermatol Allergol XXXVI 2019; (2): 196-01.
  • Reference28 Lin KC, Tsai LL, Ko EC, Sheng-Po Yuan K, Wu SY. Comorbidity profiles among patients with recurrent aphthous stomatitis: A case-control study. Journal of the Formosan Medical Association 2019; 118: 664e670.
  • Reference29 Koybasi S, Parlak AH, Serin E, Yilmaz F, Serin D. Recurrent aphthous stomatitis: investigation of possible etiologic factors. Am J Otolaryngol 2006; 27: 229e32.
  • Reference30 Marakoğlu K, Sezer RE, Toker HC, Marakoğlu I. The recurrent aphthous stomatitis frequency in the smoking cessation people. Clin Oral Invest 2007; 11: 149- 53.
  • Reference31 Subramanyam RV. Occurrence of recurrent aphthous stomatitis only on lining mucosa and its relationship to smoking possible hypothesis. Med Hypotheses 2011; 77: 185e7.
  • Reference32 Matranga D, Di Fede O, Paderni C, Albanese A, Pizzo G, Magro R, Compilato D, Campisi G. Demographic and behavioral profiles of patients with common oral mucosal lesions by a homogeneity analysis. Oral Dis, 2012,18(4):396-401

Year 2022, Volume 44, Issue 3, 233 - 238, 01.10.2022
https://doi.org/10.7197/cmj.1081601

Abstract

References

  • Reference1 Edgar NR, Saleh D, Miller RA. Recurrent Aphthous Stomatitis: A Review. J Clin Aesthet Dermatol 2017; 10(3): 26-36.
  • Reference2 Scully C. Aphthous Ulceration. NEJM 2016; 355(2): 165-72.
  • Reference3 Rivera-Hidalgo F, Shulman JD, Beach MM. The association of tobacco and other factors with recurrent aphthous stomatitis in an US adult population. Oral Dis 2004; 10: 335-45.
  • Reference4 Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Dent Assoc 2004; 135: 1279-86.
  • Reference5 Crivelli MR, Aguas S, Adler I, Quarracino C, Bazerque P. Influence of socioeconomic status on oral mucosa lesion prevalence in school children. Community Dent Oral Epidemiol 1998; 16: 58-60.
  • Reference6 Porter SR, Kingsmill V, Scully C. Audit of diagnosis and investigations in patients with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1993; 76: 449-52.
  • Reference7 Field EA, Rotter E, Speechley JA, Tyldesley WR. Clinical and haematological assessment of children with recurrent aphthous ulceration. Br Dent J 1987; 163: 19-22.
  • Reference8 Piskin S, Sayan C, Durukan N, Senol M. Serum iron, ferritin, folic acid, and vitamin B12 levels in recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol 2002; 16: 66-67.
  • Reference9 Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992; 51: 14-16.
  • Reference10 Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioğu E, Güler K, Kiraz S, Özbakkaloğlu M, Özer B, Tükek T, Durusu Tanrıöver M, Akyar E, Çağatay P, Erdem Y.. Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. Turk J Public Health 2016; 16(3): 190-03.
  • Reference11 Rivera C. Essentials of recurrent aphthous stomatitis. Biomed Rep 2019; 11(2): 47–50.
  • Reference12 Neville BW, Damm DD, Allen CM, Chi A. Oral and maxillofacial pathology. 4th ed. Philadelphia, Elsevier, 2016.
  • Reference13 Davatchi F, Tehrani-Banihashemi A, Jamshidi AR, Chams-Davatchi C, Gholami J, Moradi M, Akhlaghi M, Foroozanfar MH, Barghamdi M, Noorolahzadeh E, Samadi F, Hadj-Aliloo M, Ghaznavi K, Ghaznavi K, Soroosh M, Khabazi A, Salari AH, Sharif SK, Karimifar M, Salessi M, Essalat-Manesh K, Nadji A, Shahram F. The prevalence of oral aphthosis in a normal population in Iran: a WHO-ILAR COPCORD study. Arch Iran Med 2008; 11: 207-9.
  • Reference14 Safadi RA. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009; 9: 31. 15 Patil S, Reddy SN, Maheshwari S, Khandelwal S, Shruthi D, Doni B. Prevalence of recurrent aphthous ulceration in the Indian Population. J Clin Exp Dent 2014; 6: e36-e40.
  • Reference16 Ciçek Y, Canakçi V, Ozgöz M, Ertas U, Canakçi E. Prevalence and handedness correlates of recurrent aphthous stomatitis in the Turkish population. J Public Health Dent 2004; 64: 151–6.
  • Reference17 Özeç I, Taşveren S, Yeler D, Kılıç E. Evaluation of Prevalence of Oral Mucosa Lesions in Individuals Over 40 Years of Age in Sivas. Cumhuriyet Üniversitesi Diş Hekimliği Fakültesi Dergisi 2008; 11: 10–5.
  • Reference18 Baş Y, Seçkin HY, Kalkan G, Takcı Z, Önder Y, Çıtıl R, Demir S, Şahin Ş. Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey. Balkan Med J 2016 Jul; 33(4): 390-5.
  • Reference19 Shah K, Guarderas J, Krishnaswamy G. Aphthous stomatitis. Annals of Allergy, Asthma & Immunology 2016; 117(4): 341-3.
  • Reference20 Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2014; 62: 205e15.
  • Reference21 Saikaly SK, Saikaly TS, Saikaly LE. Recurrent aphthous ulceration: a review of potential causes and novel treatments. J of Dermatol Treat 2018; 29(6): 542-52.
  • Reference22 Wang H, He F, Xu C, Fang C, Peng J. Clinical analysis for oral mucosal disease in 21 972 cases. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018; 43:779-83.
  • Reference23 Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am 201; 58: 281-97.
  • Reference24 Chavan M, Jain H, Diwan N, Khedkar S, Shete A, Durkar S. Recurrent aphthous stomatitis: A review. J Oral Pathol Med 2012; 41: 577-83.
  • Reference25 International Study Group for Behçet's Disease. Criteria for diagnosis of Behçet's disease. Lancet 1990; 335: 1078.
  • Reference26 Livneh A, Zaks N, Katz J, Langevitz P, Shemer J, Pras M. Increased prevalence of joint manifestations in patients with recurrent aphthous stomatitis (RAS). Clin Exp Rheumatol 1996; 14(4): 407-12.
  • Reference27 Ślebioda Z, Dorocka-Bobkowska B. Systemic and environmental risk factors for recurrent aphthous stomatitis in a Polish cohort of patients. Adv Dermatol Allergol XXXVI 2019; (2): 196-01.
  • Reference28 Lin KC, Tsai LL, Ko EC, Sheng-Po Yuan K, Wu SY. Comorbidity profiles among patients with recurrent aphthous stomatitis: A case-control study. Journal of the Formosan Medical Association 2019; 118: 664e670.
  • Reference29 Koybasi S, Parlak AH, Serin E, Yilmaz F, Serin D. Recurrent aphthous stomatitis: investigation of possible etiologic factors. Am J Otolaryngol 2006; 27: 229e32.
  • Reference30 Marakoğlu K, Sezer RE, Toker HC, Marakoğlu I. The recurrent aphthous stomatitis frequency in the smoking cessation people. Clin Oral Invest 2007; 11: 149- 53.
  • Reference31 Subramanyam RV. Occurrence of recurrent aphthous stomatitis only on lining mucosa and its relationship to smoking possible hypothesis. Med Hypotheses 2011; 77: 185e7.
  • Reference32 Matranga D, Di Fede O, Paderni C, Albanese A, Pizzo G, Magro R, Compilato D, Campisi G. Demographic and behavioral profiles of patients with common oral mucosal lesions by a homogeneity analysis. Oral Dis, 2012,18(4):396-401

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section Medical Science Research Articles
Authors

Nursel ÇALIK BAŞARAN> (Primary Author)
HACETTEPE ÜNİVERSİTESİ
0000-0002-1290-6905
Türkiye


Umut KALYONCU>
Hacettepe Universiy, Medical Faculty, Internal Medicien Department, Rheumatology Division
0000-0001-7129-2109
Türkiye


Omer KARADAG>
HACETTEPE UNIVERSITY
0000-0001-6807-5066
Türkiye


Ali AKDOĞAN>
HACETTEPE UNIVERSITY
0000-0001-7592-3844
Türkiye


Abdulsamet ERDEN>
HACETTEPE UNIVERSITY
0000-0002-8084-2018
Türkiye


Levent KILIÇ>
HACETTEPE UNIVERSITY
0000-0002-3102-5847
Türkiye


Şule APRAŞ BİLGEN>
HACETTEPE UNIVERSITY
0000-0001-8208-1585
Türkiye


İhsan ERTENLİ>
HACETTEPE UNIVERSITY
0000-0002-3904-0769
Türkiye


Sedat KİRAZ>
HACETTEPE UNIVERSITY
0000-0003-2802-6061
Türkiye

Supporting Institution Turkish Society of Internal Medicine
Publication Date October 1, 2022
Published in Issue Year 2022, Volume 44, Issue 3

Cite

APA Çalık Başaran, N. , Kalyoncu, U. , Karadag, O. , Akdoğan, A. , Erden, A. , Kılıç, L. , Apraş Bilgen, Ş. , Ertenli, İ. & Kiraz, S. (2022). Recurrent Aphthous Stomatitis and Related Factors in Turkish Adult Population: A Striking Outcome of Cappadocia Chronic Diseases Epidemiological Study . Cumhuriyet Medical Journal , 44 (3) , 233-238 . DOI: 10.7197/cmj.1081601