Recurrent aphthous stomatitis (RAS) and its related factors among the Azar cohort population

BMC Oral Health. 2025 Apr 18;25(1):596. doi: 10.1186/s12903-025-05981-9.

ABSTRACT

INTRODUCTION: Recurrent aphthous stomatitis (RAS) is one of the most prevalent oral inflammatory ulcerative lesions, characterized by painful ulcers that develop on non-keratinized oral mucosa, significantly affecting the quality of life. This study aimed to evaluate the prevalence of RAS and its associated risk factors within the Azar cohort population.

METHODS: This cross-sectional study utilized data from the Azar cohort, which has been ongoing since 2014 in Shabestar City, East Azarbaijan, Iran, involving 15,006 adults aged 35 to 70 years. To assess the prevalence of RAS, participants were provided with a description of these lesions and asked whether they had ever experienced RAS in the oral cavity. Data collection was based on self-reports and examinations conducted by the physicians involved in the Azar cohort. Participants with RAS were classified into the RAS group, while the remaining participants were categorized into the non-RAS group. We assessed the association between RAS and various factors using binary logistic regression.

RESULTS: In the study population, there were 3,503 individuals in the RAS group and 11,503 individuals in the non-RAS group. The prevalence of RAS in the Azar cohort was 23.34%. Individuals over 50 years of age (p < 0.001), those with a poor (p < 0.001) or very poor (p = 0.02) socio-economic status, a low educational level (p = 0.01), smokers (p < 0.001) and individuals with a history of smoking who have since quit (p = 0.01) were significantly less affected by RAS. Conversely, individuals with genital aphthous lesions (p < 0.001), depression (p < 0.001), rheumatoid disease (p = 0.01), and food allergies (p < 0.001) were significantly more affected by RAS.

CONCLUSIONS: Factors such as being under 50 years of age, possessing a high socioeconomic status, having a higher level of education, experiencing genital aphthous disease, suffering from depression, having rheumatoid disease, and having food allergies may be associated with a higher prevalence of RAS.

PMID:40251659 | DOI:10.1186/s12903-025-05981-9