Prevalence, risk factors, and psychosocial impact of self-reported recurrent oral ulceration among Palestinian medical and dental students: a multicenter cross-sectional study

Medical and dental students face unique stressors that may predispose them to oral mucosal disorders. This study aimed to estimate the prevalence of self-reported recurrent oral ulceration (ROU) in this population and identify independent predictors, assessing the interplay between familial, traumatic, and systemic risk factors. A multicenter cross-sectional study was conducted among 557 Palestinian medical and dental students. Participants completed a validated questionnaire assessing sociodemographics, ROU history (≥ 3 episodes/year), and potential triggers including systemic disease (autoimmune and nutritional disorders), stress (PSS-10), and quality of life (UQoL). Hierarchical logistic regression and moderation analyses were performed. ROU prevalence was 71.3% (n = 397). In adjusted models, significant predictors included family history (aOR = 4.38, 95% CI 2.21–8.69), oral trauma (aOR = 4.80, 95% CI 3.06–7.54), and systemic disease (aOR = 9.83, 95% CI 2.96–32.62). Sensitivity analyses excluding Behçet’s disease revealed persistent associations for nutritional comorbidities (aOR = 25.27). Familial predisposition and oral trauma acted as independent risk factors without significant interaction. PSS-10 scores did not predict ROU (p = .387), reflecting limitations of cross-sectional stress assessment, despite 58.1% of participants attributing ulcers to stress. Self-reported ROU was common in this cohort. Family history, oral trauma, and systemic comorbidities—particularly nutritional conditions—showed strong associations with ROU, while measured stress did not. These findings suggest that student health initiatives may benefit from approaches that address systemic and nutritional factors alongside psychological support.