Table 2.
| Etiological Factors Associated with Recurrent Aphthous Stomatitis* | |
|---|---|
| Local: | Trauma |
| Smoking | |
| Dysregulated saliva composition | |
|
| |
| Microbial: | Bacterial: Streptococci |
| Viral: Varicella zoster, Cytomegalovirus | |
|
| |
| Systemic: | Behçet’s disease |
| Mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome | |
| Crohn’s disease | |
| Ulcerative colitis | |
| HIV infection | |
| Periodic fever, aphthosis, pharyngitis, and adenitis (PFAPA) or Marshall’s syndrome | |
| Cyclic neutropenia | |
| Stress; psychological imbalance, menstrual cycle | |
|
| |
| Nutritional: | Gluten sensitive enteropathy |
| Iron, folic acid, zinc deficiencies | |
| Vitamin B1, B2, B6 and B12 deficiencies | |
|
| |
| Genetic: | Ethnicity |
| HLA haplotypes | |
|
| |
| Allergic/Immunologic: | Local T-lymphocyte cytotoxicity |
| Abnormal CD4:CD8 ratio | |
| Dysregulated cytokine levels | |
| Microbe-induced hypersensitivity | |
| Sodium lauryl sulfate (SLS) sensitivity | |
| Food sensitivity | |
|
| |
| Others: | Antioxidants |
| Non-steroidal anti-inflammatory drugs (NSAIDS) | |
| Beta blockers | |
| Immunosuppressive drugs | |
*
Adapted from: Ship, II. Socioeconomic status and recurrent aphthous ulcers. J Am Dent Assoc. Jul 1966;73(1):120–123.