OD 33 - Recurrent aphthous stomatitis

Question 1

Who in the population is affected by recurrent aphthous stomatitis?

Answer 1

5-25% population

Common in higher socio-economic group

Question 2

What intra-oral layer is affected by recurrent aphthous stomatitis?

Answer 2

Non-keratinsed oral epithelium

Question 3

What defines a minor recurrent aphthous stomatitis?

Answer 3

Round shape
2-10mm
In groups of 1-5 ulcers
Lasting 7-14 days

Question 4

What defines a major recurrent aphthous stomatitis?

Answer 4

Round shape, DEEP
>10mm
In groups of 1-2 ulcers
Lasting >14 days

Question 5

What defines a herpetiform recurrent aphthous stomatitis?

Answer 5

Round shape, merging to form irregular shapes
In groups of >10 ulcers
Lasting 7-21 days
This only one that can occur in keratinised and non-keratinised mucosa
Heal with/without scarring

Question 6

What are the systemic causes of recurrent aphthous stomatitis?

Answer 6

Genetics
Haematinic deficiency - iron/ folic acid/zinc /B vitamins
Food allergy
Gluten sensitive enteropathy
Sex hormones - occasional improvement of RAS in pregnancy
Drugs
Immunodeficiency
Infections - bacteria (streptococci/H pylori) and virus’ (HSV/ CMW/ HHV6-8/ adenovirus)

Question 7

What are the local causes of recurrent aphthous stomatitis?

Answer 7

Trauma

Cessation of smoking may cause/worsen RAS

Question 8

How does genetics contribute to recurrent aphthous stomatitis?

Answer 8

40% family history

Both IL-1B and IL 6 = strong predictor

Question 9

What drugs contribute to recurrent aphthous stomatitis?

Answer 9

NSAIDs
B-Blockers
Nicorandil