Prevalence of oral recurrent aphthous stomatitis and its association with stress among a sample of Egyptian dental students: a cross-sectional study

BACKGROUND: Recurrent aphthous stomatitis (RAS) is one of the most common inflammatory ulcerative disorders that impact the oral mucosa. The etiology of aphthous ulcers is complex and multifaceted; however, emotional stress is considered one of the primary risk factors contributing to their development in younger populations. OBJECTIVES: This study aimed to determine the prevalence of RAS among a sample of dental students, its correlation with their stress levels, and to identify possible risk factors linked to these oral ulcers. METHODS: level dental students at King Salman International University using a standardized questionnaire evaluating medical and dental histories, personal habits, as well as oral hygiene practices including tooth brushing frequency and clinically relevant data regarding oral diseases, particularly RAS, alongside the 10- item Perceived Stress Scale. RESULTS: One hundred twenty-eight out of 150 students participated, 68.8% experienced RAS with females exhibiting a significantly lower likelihood of developing aphthous ulcers compared to males (OR = 0.233, p = 0.015). Daily toothbrushing was unexpectedly associated with a markedly increased risk (OR = 9.634, p < 0.001), suggesting a potential underlying mechanism warranting further investigation. Additionally, a family history of recurrent ulcers emerged as the strongest predictor (OR = 34.394, p < 0.001), highlighting a possible genetic predisposition. While poor oral hygiene demonstrated a high odds ratio (OR = 11.224), the association was not statistically significant (p = 0.059), possibly due to wide variability in the data. Similarly, high and moderate stress levels exhibited elevated odds ratios (OR = 8.716 and OR = 6.519, respectively), but their associations did not show statistical significance (p = 0.056 and p = 0.061). CONCLUSIONS: This research underscored a notable prevalence of RAS among dental students. It also identified familial history of aphthous stomatitis, presence of other dental issues, and regular daily toothbrushing as the three primary risk factors for aphthous lesions. Stress levels did not show a significant association with RAS lesions among dental students. Given that RAS is a multifactorial condition, further investigation into additional intervening factors is warranted.