Etiopathogenetic features of recurrent aphthous stomatitis: modern approaches to prevention and treatment




aphthous stomatitis, recurrence, treatment, dental prophylaxis, aphthae, mouth ulcers


Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating.

The study on RAS remains relevant over many years and continues to be a priority in modern dentistry.

The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention.

Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions.

This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention.

Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity.

Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.

Author Biographies

K. S. Hanchev, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Propaedeutical and Surgical Dentistry

O. O. Kokar, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Therapeutic, Orthopedic and Pediatric Dentistry


Gasmi Benahmed, A., Noor, S., Menzel, A., & Gasmi, A. (2021). Oral Aphthous: Pathophysiology, Clinical Aspects and Medical Treatment. Archives of Razi Institute, 76(5), 1155-1163.

Plewa, M. C., & Chatterjee, K. (2022). Aphthous Stomatitis. In StatPearls. StatPearls Publishing.

Bijelić, B., Matić, I. Z., Besu, I., Janković, L., Juranić, Z., Marušić, S., & Andrejević, S. (2019). Celiac disease-specific and inflammatory bowel disease-related antibodies in patients with recurrent aphthous stomatitis. Immunobiology, 224(1), 75-79.

Chiang, C. P., Yu-Fong Chang, J., Wang, Y. P., Wu, Y. H., Wu, Y. C., & Sun, A. (2019). Recurrent aphthous stomatitis - Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. Journal of the Formosan Medical Association = Taiwan yi zhi, 118(9), 1279-1289.

Grimaux, X., Leducq, S., Goupille, P., Aubourg, A., Miquelestorena-Standley, E., & Samimi, M. (2018). Ulcérations buccales aphtoïdes inaugurales d’une maladie inflammatoire chronique de l’intestin induite par le sécukinumab [Aphthous mouth ulcers as an initial manifestation of sécukinumab-induced inflammatory bowel disease]. Annales de dermatologie et de venereologie, 145(11), 676-682.

Borilova Linhartova, P., Janos, J., Slezakova, S., Bartova, J., Petanova, J., Kuklinek, P., Fassmann, A., Dusek, L., & Izakovicova Holla, L. (2018). Recurrent aphthous stomatitis and gene variability in selected interleukins: a case-control study. European journal of oral sciences, 126(6), 485-492.

Brignardello-Petersen, R. (2019). Patients who seek professional treatment of recurrent aphthous stomatitis probably have an increased risk of having head and neck cancer and other types of cancers. Journal of the American Dental Association (1939), 150(2), e24.

Yao, H., Zhang, Q., Song, Q., Liu, M., & Tang, G. (2022). Characteristics of Oral Mucosal Lesions and Their Association with Socioeconomic Status and Systemic Health: A Cross-Sectional Study of Consecutively Collected Oral Medicine Clinic Data in a Remote Rural Area of China. Frontiers in public health, 10, 897814.

Dalessandri, D., Zotti, F., Laffranchi, L., Migliorati, M., Isola, G., Bonetti, S., & Visconti, L. (2019). Treatment of recurrent aphthous stomatitis (RAS; aphthae; canker sores) with a barrier forming mouth rinse or topical gel formulation containing hyaluronic acid: a retrospective clinical study. BMC oral health, 19(1), 153.

Ziaei, S., Raeisi Shahraki, H., & Dadvand Dehkordi, S. (2022). The association of recurrent aphthous stomatitis with general health and oral health related quality of life among dental students. International journal of physiology, pathophysiology and pharmacology, 14(4), 254-261.

Rivera, C., Muñoz-Pastén, M., Núñez-Muñoz, E., & Hernández-Olivos, R. (2022). Recurrent Aphthous Stomatitis Affects Quality of Life. A Case-Control Study. Clinical, cosmetic and investigational dentistry, 14, 217-223.

Wen, S. D., Sans-Serramitjana, E., Santander, J. F., Sánchez, M. R., Salazar-Aguilar, P., Zepeda, A. B., Alvarado, S. I., & Miranda, I. B. (2021). Effects of natural extracts in the treatment of oral ulcers: A systematic review of evidence from experimental studies in animals. Journal of clinical and experimental dentistry, 13(10), e1038-e1048.

Hernández-Olivos, R., Muñoz, M., Núñez, E., Camargo-Ayala, P. A., Garcia-Huidobro, J., Pereira, A., Nachtigall, F. M., Santos, L. S., & Rivera, C. (2021). Salivary proteome of aphthous stomatitis reveals the participation of vitamin metabolism, nutrients, and bacteria. Scientific reports, 11(1), 15646.

Abiko, Y., Paudel, D., Matsuoka, H., Moriya, M., & Toyofuku, A. (2021). Psychological Backgrounds of Medically Compromised Patients and Its Implication in Dentistry: A Narrative Review. International journal of environmental research and public health, 18(16), 8792.

Chugh, A., Patnana, A. K., Kumar, P., Chugh, V. K., & Singh, S. (2022). The clinical efficacy of minocycline mouth rinse on recurrent aphthous stomatitis-A randomized controlled trial. Indian journal of dental research, 33(1), 24-29.

Shady, N. H., Altemani, A. H., Altemani, F. H., Maher, S. A., Elrehany, M. A., Saber, E. A., Badawi, A. M., El-Mordy, F. M. A., Mohamed, N. M., Abourehab, M. A. S., Sayed, A. M., Abdelmohsen, U. R., & Mohamad, S. A. (2022). The Potential of Corchorus olitorius Seeds Buccal Films for Treatment of Recurrent Minor Aphthous Ulcerations in Human Volunteers. Molecules (Basel, Switzerland), 27(20), 7020.

Challacombe, S. J., Alsahaf, S., & Tappuni, A. (2015, September 1). Recurrent Aphthous Stomatitis: Towards Evidence-Based Treatment? Current Oral Health Reports. Springer Science and Business Media B.V.

Edgar, N. R., Saleh, D., & Miller, R. A. (2017). Recurrent Aphthous Stomatitis: A Review. The Journal of clinical and aesthetic dermatology, 10(3), 26–36.

Montgomery-Cranny, J. A., Wallace, A., Rogers, H. J., Hughes, S. C., Hegarty, A. M., & Zaitoun, H. (2015). Management of Recurrent Aphthous Stomatitis in Children. Dental update, 42(6), 564-572.

Zahid, E., Bhatti, O., Zahid, M. A., & Stubbs, M. (2022). Overview of common oral lesions. Malaysian family physician, 17(3), 9-21.

Yousef, N. J., Aljoujou, A. A., Mashlah, A. M., & Hajeer, M. Y. (2022). Assessment of the Effectiveness of Aloe vera Versus Amlexanox in the Treatment of Recurrent Aphthous Ulcers: A Three-Arm Placebo-Controlled Randomized Clinical Trial. Cureus, 14(10), e30693.

Manfredini, M., Guida, S., Giovani, M., Lippolis, N., Spinas, E., Farnetani, F., Dattola, A., Di Matteo, E., Pellacani, G., & Giannetti, L. (2021). Recurrent Aphthous Stomatitis: Treatment and Management. Dermatology practical & conceptual, 11(4), e2021099.

Ward, M., Maliyar, K., & Gooderham, M. (2021). A case report of recalcitrant aphthous ulcers in two patients treated with interleukin-17 inhibitors. SAGE open medical case reports, 9, 2050313X211034925.

Kavita, K., Singh, R., Singh, R., Gonuguntla, S., Luke, A. M., & Jois, H. S. (2020). Assessment of Efficacy of 5% Topical Amlexanox and 0.1% Topical Triamcinolone Acetonide in Management of Recurrent Aphthous Stomatitis. Journal of pharmacy & bioallied sciences, 12(Suppl 1), S444-S447.

Langlais, R. P., Miller, C. S., & Gehrig, J. S. (2020). Color atlas of common oral diseases. Jones & Bartlett Learning.

Savichuk, O., Zaitseva, E., Nemirovich, Yu., & Beketova, G. (2015). Likuvannia khronichnoho retsydyvuiuchoho aftoznoho stomatytu [Treatment of chronic recurrent aphthous stomatitis]. Sovremennaya stomatologiya, (2), 37-39. [in Ukrainian].

Volosovets, T. M., & Feleshtynska, O. Ya. (2021). Otsinka efektyvnosti diahnostyky ta likuvalnoi taktyky khronichnoho retsydyvuiuchoho aftoznoho stomatytu [Evaluation of the effectiveness of diagnosis and treatment tactics of chronic recurrent aphthous stomatitis]. Visnyk stomatolohii, 35(1), 22-26. [in Ukrainian].

Montgomery-Cranny, J. A., Wallace, A., Rogers, H. J., Hughes, S. C., Hegarty, A. M., & Zaitoun, H. (2015). Management of Recurrent Aphthous Stomatitis in Children. Dental update, 42(6), 564-572.

Sánchez-Bernal, J., Conejero, C., & Conejero, R. (2020). Recurrent Aphthous Stomatitis. Aftosis oral recidivante. Actas dermo-sifiliograficas, 111(6), 471-480.

Wang, H., He, F., Xu, C., Fang, C., & Peng, J. (2018). Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 43(7), 779-783.




How to Cite

Hanchev KS, Kokar OO. Etiopathogenetic features of recurrent aphthous stomatitis: modern approaches to prevention and treatment. Zaporozhye medical journal [Internet]. 2023Jul.20 [cited 2024Apr.20];25(4):360-4. Available from: