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ORIGINAL STUDY ARTICLE
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 53-55

Prevalence and family history of recurrent aphthous stomatitis among the students of a dental institution in south India


1 Department of Oral Pathology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
2 Department of Biochemistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
3 Department of Oral Pathology, Kalinga Institute of Dental Sciences, Bhubaneswar, Odisha, India
4 Department of Conservative Dentistry and Endodontics, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
5 Department of Physiology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India

Date of Web Publication31-Dec-2014

Correspondence Address:
Dr. Thangadurai Maheswaran
Department of Oral Pathology, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode - 637 205, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-3019.148250

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  Abstract 

Background: Positive family history is reported to be associated with Recurrent Aphthous Stomatitis (RAS), but the family history of people without RAS is not reported. Aim: To find the details of family history of people with and without RAS. Materials and Methods: Data regarding the lifetime prevalence andthe family history of RAS was collected from 264 female clinical students of a dental institution and analyzed for any correlation. Results: The self-reported lifetime prevalence of RAS was found to be 53% among the dental students of our institution. Positive family history was found in 63% of students with RAS and in 22% of the students without RAS. Conclusions: RAS is very common among female dental students and the positive family history is an important predisposing factor.

Keywords: Aphthous stomatitis, aphthous ulcer, oral ulcer


How to cite this article:
Maheswaran T, Yamunadevi A, Ayyappan S, Panda A, Sivakumar JS, Vaithiyanadane V. Prevalence and family history of recurrent aphthous stomatitis among the students of a dental institution in south India. J Indian Acad Dent Spec Res 2014;1:53-5

How to cite this URL:
Maheswaran T, Yamunadevi A, Ayyappan S, Panda A, Sivakumar JS, Vaithiyanadane V. Prevalence and family history of recurrent aphthous stomatitis among the students of a dental institution in south India. J Indian Acad Dent Spec Res [serial online] 2014 [cited 2019 Jun 25];1:53-5. Available from: http://www.jiadsr.org/text.asp?2014/1/2/53/148250


  Introduction Top


Recurrent Aphthous Stomatitis (RAS) is defined as recurrent episodes of oral aphthous ulceration where the ulcers heal spontaneously with subsequent recurrence. [1] RAS is the common oral mucosal disorder affecting non-keratinized mucosa causing much pain and interference with mastication and speech. Based on the size and the number of ulcers, RAS is classified as minor, major, and herpetiform. [2] Although the exact etiology of RAS is not clear, genetics, trauma, vitamin deficiency, microbes, and psychological stress are cited as predisposing factors. [3] A genetic predisposition for the aphthous ulcer is suggested as about 40% of patients having a positive family history. [4] Many reports are available in the scientific literature about the family history of RAS among the subjects with RAS, but the family history among the subjects without RAS seems to be unexplored. Hence, this study was proposed with an objective to find the details about the family history of both the subjects with or without the RAS. Since the clinical students of a dental institution are assumed to have sufficient knowledge about the RAS, information about the family history of RAS will be reliable. Also, the participants are expected to co-operate well for this study since they are familiar with the investigating dentist.


  Materials and Methods Top


Questionnaire-based cross-sectional study was carried out among the 264 undergraduate female dental students of our institution in south India excluding the preclinical students, to collect the data about the life time prevalence of RAS. Most of the study participants belong to the age group of 19-23 years and all of them are hostel inmates having similar diet. The objective of this study was explained and each study participant was asked to find the prevalence of RAS among their parents and siblings. This family history of RAS was collected from both the group of students reported with and without the lifetime history of RAS. The data collected on paper forms was entered in a Microsoft Excel spreadsheet and analyzed for any correlation between the prevalence of RAS with family history.


  Results Top


The lifetime prevalence of RAS among the 264 dental students was found to be 53% (n = 140). The distribution of positive family history is provided in the [Table 1]. Among the 140 students with history of RAS, 63% have positive family history, whereas 124 students without the history of RAS, 22% have positive family history. This is statistically highly significant (P < 0.001). The details of positive family history are provided in the [Table 2]. When the association between the positive history among the family members with the prevalence of RAS was analyzed individually, positive history of RAS in father, mother, and brother was found to be statistically highly significant (P < 0.001), but positive history of RAS in sisters was found to be not significant (P > 0.05).
Table 1: Distribution of positive family history

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Table 2: Details of positive family history among the students

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  Discussion Top


The lifetime prevalence of RAS among the female students of our dental institution was found to be 53%. Findings of similar studies are presented in the [Table 3]. [5],[6],[7],[8],[9],[10] The prevalence of RAS varies depending upon the method and group of population studied. [11] However, RAS is the most common oral ulcerative condition found in the clinical practice. [1] RAS is reported to be more common among the females, among third decade, and among the students. [6],[10] Even though 63% of students with RAS have positive family history, the genetic aspect need not be considered as etiology, but only as a predisposing factor, because 22% of students without RAS also have positive family history. Inheritance of specific genetic polymorphism related to proinflammatory cytokines is suggested for explaining the family history of RAS. [11] In subjects with RAS, an enhanced immunologic response is assumed to occur due to some trigger factors like mechanical injury, stress, or bacterial and viral antigens. Higher prevalence of aphthous among relatives indicates the genetic background of the condition. [11] Even though significant association was found between prevalence of RAS and positive family history, further studies are warranted to explain the absence of significant association between prevalence of RAS and positive history among the sisters.
Table 3: Findings of similar studies about recurrent aphthous stomatitis[5],[6],[7],[8],[9],[10]

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Point prevalence of RAS among the 3,244 patients attending the Jodhpur Dental College was found to be 22% which is different from the lifetime prevalence. [12] Point prevalence and life time prevalence among the 341 dental students of Manipal was reported to be 7% and 67%, respectively. [7] The prevalence of RAS among the dental patients or dental students should not be extrapolated for the prevalence of RAS among the general population, because the predisposing factors like age, stress, nutritional status may not be similar. For example, the point prevalence of RAS is found to decrease with age. [6] One of the limitations of this study is that the clinical examination was not conducted to confirm the RAS among the study participants and their family members resulting in some amount of subjective component in our results. Also, the frequency, the severity, and the point prevalence of RAS were not assessed in this study.


  Conclusion Top


The lifetime prevalence of RAS was found to be 53% among the female dental students of our institution. There is significant association between the presence of RAS among the female dental students and positive family history.

 
  References Top

1.
Liang MW, Neoh CY. Oral aphthosis: Management gaps and recent advances. Ann Acad Med Singapore 2012;41:463-70.  Back to cited text no. 1
    
2.
Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: A review of the growing knowledge. Int J Oral Maxillofac Surg 2004;33:221-34.  Back to cited text no. 2
    
3.
Preeti L, Magesh K, Rajkumar K, Karthik R. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2011;15:252-6.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Scully C, Porter S. Oral mucosal disease: Recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 2008;46:198-206.  Back to cited text no. 4
    
5.
Embil JA, Stephens RG, Manuel FR. Prevalence of recurrent herpes labialis and aphthous ulcers among young adults on six continents. Can Med Assoc J 1975;113:627-30.  Back to cited text no. 5
[PUBMED]    
6.
Miller MF, Ship II. A retrospective study of the prevalence and incidence of recurrent aphthous ulcers in a professional population, 1958-1971. Oral Surg Oral Med Oral Pathol 1977;43:532-7.  Back to cited text no. 6
[PUBMED]    
7.
Pratibha PK, Prerna J, Meena AK, Bhat KM, Chakravarthy, Bhat GS. Association of recurrent aphthous ulcers with stress among students in an Indian dental institution. Natl J Integr Res Med 2012;3:141-7.  Back to cited text no. 7
    
8.
Byahatti SM. Incidence of recurrent apthous ulcers in a group of student population in Libya: A Questionnaire Study. Arch Craniorofac Sci 2013;1:26-30.  Back to cited text no. 8
    
9.
Safadi RA. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009;9:31.  Back to cited text no. 9
    
10.
Abdullah MJ. Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City. J Clin Exp Dent 2013;5:e89-94.  Back to cited text no. 10
    
11.
Slebioda Z, Szponar E, Kowalska A. Recurrent aphthous stomatitis: Genetic aspects of etiology. Postepy Dermatol Alergol 2013;30:96-102.  Back to cited text no. 11
    
12.
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:e36-40.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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