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ORIGINAL ARTICLE
Year : 2012  |  Volume : 53  |  Issue : 1  |  Page : 9-11  

The effect of dietary habits on the development of the recurrent aphthous stomatitis


1 Department of Oral Medicine and Diagnostic Science, Alfarabi College of Dentistry, Riyadh, Kingdom of Saudi Arabia, Pathology, Faculty of Dentistry, Aleppo University, Syria
2 Department of Orthodontic and Pediatric Dentistry, Alfarabi College of Dentistry, Riyadh, Kingdom of Saudi Arabia, Pediatric Dentistry, Faculty of Dentistry, Al-Baath University, Syria
3 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aleppo University, Syria

Date of Web Publication18-Aug-2012

Correspondence Address:
Bassel Tarakji
Alfarabi Dental School, Kingdom of Saudi Arabia

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0300-1652.99822

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   Abstract 

Background: The aim was to assess the relationship between the dietary habits and development of recurrent aphthous stomatitis. Materials and Methods: Two groups (30 patients with RAS who have been following dietary habits and not associated with systemic disease or hematologic abnormalities, and the control group consist of 28 patients without recurrent aphthous stomatitis). Results: A Mann-Whitney test (P>0.05) shows no significance difference between the patients with RAS and the control group. Both groups eating similar food such as cheese, cow's milk, tea, lemon, coffee, orange, apple, yoghurt, and tomato, spicy food, but the patients with RAS ate specific foods containing (pH) like; oranges and lemons more frequently than the control group. Conclusion: Dietary habits have no important role in development of RAS but can lay a minor role in the pathogenesis of RAS either by causing hypersensitivity or by deficiency of some vitamins and minerals.

Keywords: Aphthous stomatitis, dietary habits, recurrent


How to cite this article:
Tarakji B, Baroudi K, Kharma Y. The effect of dietary habits on the development of the recurrent aphthous stomatitis. Niger Med J 2012;53:9-11

How to cite this URL:
Tarakji B, Baroudi K, Kharma Y. The effect of dietary habits on the development of the recurrent aphthous stomatitis. Niger Med J [serial online] 2012 [cited 2024 Mar 28];53:9-11. Available from: https://www.nigeriamedj.com/text.asp?2012/53/1/9/99822


   Introduction Top


Recurrent aphthous stomatitis RSA is a common oral disorder occurring in up to 25-30 of population. The etiology of this disease is unknown; therefore many predisposing factors may have an important role in development of RAS such as heredity, bacteriology, trauma, endocrinology, and nutrition. Also many studies have demonstrated that iron, folate; vitamin B1, B2, B6, B12 deficiencies, and sensitivity to some foods in patients with RAS. [1] This study is aimed to evaluate the relationship between dietary habits and RAS.


   Materials and Methods Top


A total of 50 patients have refereed to my clinic complaining of RAS. Only 30 patients out of 50 participated in this study.

All of those 30 patients (17 male, 13 female, maximum age 45 years, minimum age 22 years) have followed dietary habits . The patients with RAS and the control group were assessed and questioned by the specialist in nutrition about the daily intake frequencies of some foods which are frequently consumed in Syria, and their effects on RAS. The Research Ethics Committee at Alfarabi College of dentistry provided a favorable ethical opinion.

The medical history of those patients has demonstrated that RAS occurred at least more than four times per years.

Twelve patients out of 50 were not included in this study because some of those patients have hematologic abnormalities or systemic disease. Also eight patients out of 50 were not included in this study because they do not follow any dietary programmers.

The control group consists of 28 patients without recurrent aphthous stomatitis.

Statistics analysis

A Mann-Whitney test and correlation test have been used.


   Results Top


All the clinical data of the participant patients in this study is shown in [Table 1].
Table 1: Clinical features of recurrent aphthous stomatitis

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The range of the patient's age is (22-45), the maximum age is 45, and minimum is 22.

The Mann-Whitney test (P>0.05) shows that there was no significance difference between the patients with RAS and the control group; moreover, the patients with RAS were found to eat similar foods like cheese, cow's milk, tea, lemon, coffee, orange, yoghurt and tomato, spicy food; but the patients with RAS ate specific foods containing (ph) like oranges and lemons more frequently than the control group [Table 2]. Also the correlation test has shown there was no correlation between the age and gender and occurrence of RAS for the patients with RAS followed dietary habits.
Table 2: Comparison of the types of food for patients with RAS and the control group

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   Discussion Top


Safadi [2] has reported that 82% of the participant patients claimed that the RAS interfered with food eating and swallowing. Some researchers have indicated that the development of RAS is associated with the use of some certain foods: Cows' milk, gluten, chocolate, nuts, cheese. [3],[4],[5],[6] Eversole et al. [7] found no significant association between RAS and three specific food (tomatoes, strawberries, and walnuts). Wilson [8] has noted an increased prevalence of atopy among RAS patients.

Wray [5] has mentioned that there is no significant difference in the incidence of atopy in RAS patients compared with the normal population. Hay and Reade [9] have demonstrated that there is relationship between RAS and consuming some food items such as figs, cheese, tomato, tomato sauce, vinegar, lemon, pineapple, milk, cheese, wheat flour. They have concluded that the removal of the dietary habits can reduce the frequency of RAS. Wright et al. [10] reported that the food allergy was a significant factor in the development of RAS, but they did not find a relationship between gluten containing foods and the occurrence of RAS. Ogura et al., [11] have mentioned that the patients with RAS consume foods containing calcium, iron, vitamin B1, and vitamin C less frequently than the control patients and concluded that the deficiencies of some vitamins and minerals might play a role in the pathogenesis of RAS. Kozlak et al. [12] have suggested that consuming sufficient amounts of the vitamins B12 and folate may be a useful strategy to reduce the number and/or duration of RAS episodes.


   Conclusion Top


Dietary habits have no important role in development of RAS but can be playing a minor role in the pathogenesis of RAS either by causing hypersensitivity or by deficiency of some vitamins and minerals.

This study has shown that RAS patients ate acidic pH-containing foods like oranges and lemons more frequently than controls and this might have initiated RAS lesions as irritation factors. The other patients might have hypersensitivity to specific food such as yoghurt and tomato, and spicy food.

 
   References Top

1.Natah SS, Konttien YT, Ennatah NS, Ashammakhi N, Sharkey KA, Hayrien-Immonen R. Recurrent aphtous ulcers today: A review of the growing knowledge. Int J Maxillofac Surg 2004;33:221-34.  Back to cited text no. 1
    
2.Safadi RA. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009;9:31.  Back to cited text no. 2
    
3.Thomas HC, ferguson A, Mclennan JG, Mason DK. Food antibodies in oral disease: A study of serum antibodies to food proteins in aphthous ulceration and other oral disease. J Clin Pathol 1973:26:371-4.  Back to cited text no. 3
    
4.Miller MF, Shipp 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. 4
    
5.Wray D, Vlagopoulus TP, Siraganian RP. Food allergens and basophil histamine release in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982:54:388-95.  Back to cited text no. 5
    
6.Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984:57:504-7.  Back to cited text no. 6
    
7.Eversole LE, Shopper TP, Chambers DW. Effects of suspected foodstuff challenging agents in the etiology of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982:54:33-8.  Back to cited text no. 7
    
8.Wilson CW. Food sensitivities, taste changes, aphthous ulcers and atopic symptoms in allergic disease. Ann Allergy 1980:44:302-7.  Back to cited text no. 8
    
9.Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphtous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984;57:504-7.  Back to cited text no. 9
    
10.Wright A, Ryan FP, Willingham SE, Holt S, Page AC, Hindle MO, et al. Food allergy or intolerance in severe recurrent aphtous ulceration of the mouth. Br Med J (Clin Res Ed) 1986;292:1237-8.  Back to cited text no. 10
    
11.Ogura M, Yamamato T, Morita M, Watanabe T. A case-control study on food intake of patients with recurrent aphtous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:45-9.  Back to cited text no. 11
    
12.Kozlak ST, Walsh SJ, Lalla RV. Reduced dietary intake of vitamin B12 and folate in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2010;39:420-3.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2]


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