Effect of stressful life events on the onset and duration of recurrent aphthous stomatitis

Abstract

Background Recurrent Aphthous Stomatitis (RAS) is a common and painful oral mucosal disease. Possible etiologies include genetics, vitamin deficiencies, trauma, immune dysfunction and stress. The goal of the present study was to examine the relationship between the occurrence, type, and magnitude of stressful events and the onset and duration of RAS episodes. Methods 160 subjects with a history of RAS completed a weekly phone survey for up to one year, providing data on the occurrence of RAS episodes and details of any stressful events they experienced during the previous week. During RAS episodes, subjects also completed daily paper diaries that recorded incidence and duration of the RAS episode. Stressful events were quantified using the validated Recent Life Changes Questionnaire (RLCQ), and were classified as mental or physical stressors. Results Stressful life events were significantly associated with the onset of RAS episodes (p<0.001), however not with duration of the RAS episodes. Experiencing a stressful life event increased the odds of an RAS episode by almost three times (OR=2.72; 95% CI 2.04-3.62). When controlled for each other, mental stressors had a larger effect (OR=3.46, 95% CI=2.54-4.72) than physical stressors (OR=1.44; 95% CI 1.04-1.99) on the occurrence of RAS episodes. RAS episodes did not occur more frequently or last longer with increasing stress severity. Conclusions In patients with a history of RAS, stressful events may mediate changes involved in initiation of new RAS episodes. Mental stressors are more strongly associated with RAS episodes than physical stressors.

Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey

“…The mechanism of stress in this issue is not clear. However, it probably has its effects via multiple system changes like the production and activity of lymphocytes, and the production of cytokines and antibodies (12). Another possible mechanism is its ability to induce the para-functional habits, like biting the lips of the cheek and its forming predisposition due to trauma (1).…”

Evaluation of the Prevalence of Oral and Maxillofacial Diseases in Submarine Navy Personnel of the Army of the Islamic Republic of Iran

“…(33,34). In some studies, a direct relationship has been reported between stress and the occurrence of aphthous stomatitis (8,9,(33)(34)(35)(36)(37). Such a relationship could not be found in some other studies (38,39).…”

Tratamento da estomatite aftosa recorrente: uma revisão integrativa da literatura

“…Essas úlceras apresentam-se de forma dolorosa, levando a um impacto negativo na qualidade de vida dos pacientes 11 , podendo restringir a ingestão de alguns alimentos e também comprometer uma adequada higiene oral, possibilitando um maior acúmulo de biofilme oral, o que aumenta o risco para o desenvolvimento de outros agravos bucais, como a doença periodontal e a cárie dentária 12 . Dessa forma, a EAR representa um problema que requer atenção, devido à sua alta prevalência e associação com dor e influência na qualidade de vida dos indivíduos afetados 13 . Como tratamento, são indicados variados agentes terapêuticos, dentre eles, medicamentos sistê-micos e agentes tópicos têm sido utilizados na redução dos sintomas e na busca de uma acelerada regeneração dessa lesão 14,15 , tais como a utilização de produtos naturais 16 , antibióticos 5 , anti-inflamatórios 17 , vitaminas 18 ou laser 19 .…”