title: Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices?
abstract: BACKGROUND
  Recurrent aphthous stomatitis (RAS) is a common oral mucosal disease, characterized by painful oral ulcerations whose causes is poorly understood. The aim of the present study was to assess the characteristics of patients suffering from RAS.
  
  
  METHODS
  Five hundred and twenty-eight consecutive patients attending an Oral Medicine Specialist Clinic in the UK were examined and 143 specific attributes recorded.
  
  
  RESULTS
  Patients with a clinical diagnosis of RAS were significantly more often males (P = 0.001) younger (P < 0.001). Significant correlations were observed between a diagnosis of RAS and trauma (P = 0.044), stress (P = 0.006), non-smoking (P < 0.001), a family history (P < 0.001), breast feeding (P = 0.017) and the site in the mouth (buccal, labial, floor of mouth) (P < 0.007).
  
  
  CONCLUSIONS
  This retrospective analysis of patients attending a tertiary referral center provides evidence to support some long held beliefs about RAS, such as young age of onset, sites affected, and associations with trauma, stress, familial history and hormonal changes, while raising a new and interesting decreased incidence with breast feeding.
authors.affiliation: Oral Medicine, School of Dental Science, University of Melbourne, CRC Oral Health Science, Parkville, Australia. m.mccullough@unimelb.edu.au
authors.forename: Michael John
authors.initials: MJ
authors.lastname: McCullough
authors.forename: Samah
authors.initials: S
authors.lastname: Abdel-Hafeth
authors.forename: Crispian
authors.initials: C
authors.lastname: Scully
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001942:Breast Feeding / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005151:Facial Injuries / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D012189:Retrospective Studies; D012744:Sex Ratio; D012907:Smoking; D013281:Stomatitis, Aphthous / Q000209:etiology* / Q000473:pathology; D013315:Stress, Psychological / Q000150:complications