Association of Recurrent Aphthous Ulcers With Stress Among Students In An Indian Dental Institution
Recurrent Aphthous Ulcers With Stress Among Students
DOI:
https://doi.org/10.70284/njirm.v3i3.2053Keywords:
Prevalence, Recurrent aphthous ulcer, Stress,StudentsAbstract
Background: Recurrent aphthous ulcers are painful oral lesions with no proven effective treatment. A definitive cause of these ulcerations still remains elusive. It is believed that psychological stress may be a significant contributor. Aim: The aim of the present study was to determine whether there was any significant association of Recurrentaphthous ulcers with episodes of stress by determining the prevalence of ulcers and levels of stress tolerance among dental students. Materials and methods: A cross sectional survey was carried out on 341 students of Manipal College of Dental Sciences, Manipal, India by distributing questionnaires. The questionnaire had two sections, the first part dealt with ulcers and the later part comprised of a perceived stress scale. The data collected was analyzed with Independent sample t test and ANOVA with post hoc Tukey’s test using the SPSS 16 version software. Results: Prevalence of ulcer was found to be 66.9%. Comparison of mean stress scores between the ‘ulcer-experienced’ and ulcer-free groups showed no difference. Assessment of stress among undergraduates, interns and post graduates who had reported ulcer experience revealed that interns were able to handle the stressful situations significantly better than under graduates and post graduates. Conclusion: The present study did not show any association between episodes of ulcers and stressful events.
References
2. Scully C, Gorsky M, Lozada – Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003; 134: 200 – 207.
3. Woo SB, Sonis ST. Recurrent aphthous ulcers: a review of diagnosis and treatment. J Am Dent Assoc 1996; 127: 1202 – 1213.
4. Casiglia JM. Recurrent aphthous stomatitis: etiology, diagnosis and treatment. Gen Dent 2002; 50: 157 -166.
5. Vincent SD, Lilly GE. Clinical, historic and therapeutic features of aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1992; 74: 79 - 86.
6. Ship JA, Chavez EM, Doerr PA, Henson BS. Recurrent aphthous stomatitis. Quintessence Int 2000; 31: 95 – 112.
7. Gallo CB, Mimura MAM, Sugaya NN. Psychological stress and recurrent aphthous stomatitis. Clinics 2009; 64(7): 645 – 648.
8. Murphy L, Denis R, Ward CP and Tartar JL. Academic stress differentially influences perceived stress, salivary cortisol and immunoglobulin – A in undergraduate students. Stress 2010; 13: 365 – 370.
9. Ship II, Brightman VJ, Laster LL. The patient with recurrent ulcers and the patient with recurrent herpes labialis: A study of two population samples. J Am Dent Assoc 75:645, 1967.
10. Cohen S, Kamarck T, and Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior 1983; 24: 386-396.
11. Ship JA. Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81: 141 – 147.
12. Donatsky O. Epidemiologic study on recurrent aphthous ulcerations among 512 Danish dental students. Community Dent Oral Epidemiol 1973; 1: 37 – 40.
13. Schneider LC, and Schneider AE. Diagnosis of oral ulcers 1998; 65(5 & 6): 383 – 387.
14. Safadi AR. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009; 9: 31.
15. Budtz-Jorgensen E. Oral mucosal lesions associated with the wearing of removable dentures. Journal of Oral Pathology and Medicine 1981; 10 ( 2): 65 – 80.
16. Kvam E, Gjerdet NR, Bondevik O. Traumatic ulcers and pain during orthodontic treatment. Comm Dent Oral Epidemiol 1987; 15 (2): 104 – 107.
17. Scully C, Gorsky M, Lozada – Nur F. The diagnosis and management of recurrent aphthous stomatitis. A consensus approach. JADA 2003; 134: 200 – 207.
18. Field AE, Rotter E, Speechley JA, Tyldesley WR. Clinical and haematological assessmentof children with recurrent aphthous ulceration. Br Dent J 1987: 163: 19 – 22.
19. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992; 51 (2): 14 -16.
20. Grady D, Ernster VL, Stillman L, Greenspan J. Smokeless tobacco use prevents aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1992; 74 (4): 463 – 465.
21. Chattopadhyay A, Chatterjee S. Risk indicators for recurrent aphthous ulcers among adults in the US. Community Dent Oral Epidemiol 2007 Apr; 35(2): 152 – 159.
22. Axell T, Henricsson V. Association between recurrent aphthous ulcers and tobacco habits. Eur J Oral Sci June 1985; 93(3): 239 – 242.
23. Ship II. Inheritance of aphthous ulcers of the mouth. J Dent Res 1965; 44: 837 – 844.
24. Albanidou-Farmaki E, Kayavis IG, Polymenidis Z, Papanayotou P. HLA-A, B, C and DR antigens in recurrent oral ulcers. Ann Dent 1988: 47: 5–8.
25. Shohat-Zabarski R, Kalderon S, Klein T, Weinberger A. Close association of HLA-B51 in persons with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992: 74: 455–458.
26. Pedersen A. Psychologic stress and recurrent aphthous ulceration. J Oral Pathol Med 1989Feb; 18(2): 119 – 122.
27. McCartan BE, Lamey PJ, Wallace AM. Salivary cortisol and anxiety in recurrent aphthous stomatitis. Journal of Oral Pathology & Medicine 1996; 25(7): 357 – 359.
28. Soto – Araya M, Rojas – Alcayaga G, Esguep A. Association between psychological diorders and the presence of Oral lichen planus, Burning mouth syndrome and Recurrent aphthous stomatitis. Med. Oral 2004; 9: 1 -7.
29. Albanidou-Farmaki E, Poulopoulos AK, Epivatianos A, Farmakis K, Karamouzis M and Antoniades D. Increased anxiety level and high salivary and serum cortisol concentrations in patients with recurrent
aphthous stomatitis. Tohoku J Exp Med 2008; 214: 291 – 296.
30. Kasi PM, Khawar T, Khan FH, Kiani JG, Khan UZ, Khan HM, Khuwaja UB and Rahim M. Studying the association between postgraduates trainees’ work hours, stress and the use of maladaptive coping strategies. J Ayub Med Coll Abbottabad 2007;19 (3): 37 – 41.
31. Paterson AJ, Lamb AB, Clifford TJ & Lamey PJ. Burning mouth syndrome: the relationship between the HAD scale and parafunctional habits. J Oral Pathol Med 1995; 24: 289 – 292.
32. Willcock SM, Daly MG, Tennant CC and Allard BJ. Burnout and psychiatric morbidity in new medical graduates. The Medical Journal of Australia 2004; 181(7): 357 – 360.
33. Clark DC, Salazar-Gruesco, Grabler P, Fawcett J. Predictors of depression during the first 6 months of internship. Am J Psychiatry 1984; 141: 1095 -1098.
34. Lam TP, Wong JG, Ip MS, Lam KF, Pang SL. Psychological well-being of interns in Hong Kong: what causes them stress and what helps them. Med Teach 2010; 32 (3): e120 - 126.