What are predisposing factors in the pathogenesis of recurrent aphthous stomatitis (RAS)?

Updated: May 11, 2020
  • Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Predisposing factors may include any of the following:

  • Stress - This underlies RAS in some cases; ulcers appear to exacerbate during school or university examination times.

  • Trauma - Biting of the mucosa and wearing of dental appliances may lead to some ulcers; RAS is uncommon on keratinized mucosae.

  • Endocrine factors in some women - RAS is clearly related to the progestogen level fall in the luteal phase of the menstrual cycle, and ulcers may then temporarily regress in pregnancy.

  • Cessation of smoking - This may precipitate or exacerbate RAS in some cases.

  • Allergies to food - Food allergies occasionally underlie RAS; the prevalence of atopy is high. Patients with aphthae may occasionally have a reaction to cow's milk and may have been weaned at an early age.

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