The effect of smoking and nicotine dependence in recurrent aphthous stomatitis

Year 2016, , 126 - 31, 18.08.2016

Zühre Zafersoy Akarslan , İlkay Peker

https://doi.org/10.17214/aot.65572

Abstract

OBJECTIVE: The aim of this study was to assess the self-reported recurrent aphthous stomatitis (RAS) history, trigger factors of the lesions, smoking habits and nicotine dependence among a group of patients attending a dental faculty.

MATERIALS and METHOD: 503 patients participated in this study (257 females, 246 males; age range 16-76 years). Sociodemographic characteristics, history of any RAS, trigger factors of the lesions, smoking habits and nicotine dependence of the patients were recorded on a standard form. Nicotine dependence was assessed according to Fagerstrom Test for Nicotine Dependence (FTND).

RESULTS: One hundred and sixty seven patients (33.2%) reported a history of RAS. Gender and education level did not have an effect on this lesion (p=0.100 and p=0.906, respectively). The most reported trigger factor was stress (60.9%), followed by flu/cold (47.5%). Non-smokers more often reported a lesion history compared to smokers and ex-smokers (p=0.000). The mean FTND score of patients with history of RAS was significantly greater than that of patients with no history of RAS (p=0.011).

CONCLUSION: About one third of the patients had a history of RAS, and the most reported trigger factor of the lesion was found to be stress. A positive history of RAS was more often reported by non-smokers. Among smokers, nicotine dependence had an effect on the occurrence of the lesion.

Keywords

Dentistry, smoking, stomatitis, aphthous, tobacco use disorder

Rekürrent aftöz stomatit oluşumunda sigara kullanımı ve nikotin bağımlılığının etkisi

Abstract

AMAÇ: Bu çalışmanın amacı diş hekimliği fakültesine başvuran bir grup hastanın beyanına göre rekürrent aftöz stomatit (RAS) hikayesi, RAS oluşumunu etkileyen faktörler, sigara kullanımı ve nikotin bağımlılığının değerlendirilmesidir.

GEREÇ ve YÖNTEM: Çalışmaya 503 hasta dahil edildi (257 kadın, 246 erkek; yaş aralığı 16-76). Hastaların sosyo-demografik özellikleri, RAS hikayesi olup olmadığı, lezyon oluşumunu etkileyen faktör veya faktörler, sigara içme alışkanlıkları ve nikotin bağımlılık derecesi standart bir forma kaydedildi. Nikotin bağımlılığı Fagerström Nikotin Bağımlılık Testi (FNBT) ile değerlendirildi.

BULGULAR: 167 hasta (%33.2) RAS hikayesi olduğunu belirtti. Lezyon oluşma hikayesi ile cinsiyet ve eğitim seviyesi arasında anlamlı fark bulunmadı (p=0.100 ve p=0.906). Lezyon oluşumunu en fazla tetikleyen faktörün stres olduğu (%60.9), bunu nezle/grip’in takip ettiği (%47.5) bulgulandı. Hiç sigara kullanmamış hastalardaki RAS hikayesinin sigara içenlere ve içip bırakanlara göre anlamlı olarak daha yüksek olduğu saptandı (p=0.000). RAS hikayesi olan hastaların FNBT skor ortalamasının RAS hikayesi olmayan hastalarınkine göre daha yüksek olduğu belirlendi (p=0.011).

SONUÇ: Hastaların yaklaşık üçte birinde RAS hikayesi olduğu ve lezyonların oluşumunu etkileyen faktörler arasında en fazla stresin bildirildiği saptandı. Sigara içmeyen bireylerde lezyon oluşum hikayesinin daha yüksek oranda rapor edildiği belirlendi. Sigara içen bireylerde nikotin bağımlılığının lezyon gelişiminde etkisi olduğu saptandı.

Keywords

Diş hekimliği, sigara içme, stomatit, aftöz, tütün kullanımı bozuklukları

References

• Motamedi MR, Golestannejad Z. Use of pure nicotine for the treatment of aphthous ulcers. Dent Res J (Isfahan) 2015;12:197-8.
• McRobbie H, Hajek P, Gillison F. The relationship between smoking cessation and mouth ulcers. Nicotine Tob Res 2004;6:655-9.
• Bazrafshani MR, Hajeer AH, Ollier WE, Thornhill MH. IL-1B and IL-6 gene polymorphisms encode significant risk for the development of recurrent aphthous stomatitis (RAS). Genes Immun 2002;3:302–5.
• Kalra R, Singh SP, Savage SM, Finch GL, Sopori ML. Effects of cigarette smoke on immune response: Chronic exposure to cigarette smoke impairs antigen-mediated signaling in T cells and depletes IP3- sensitive Ca (2+) stores. J Pharmacol Exp Ther 2000;293:166–71.
• Subramanyam RV. Occurrence of recurrent aphthous stomatitis only on lining mucosa and its relationship to smoking--a possible hypothesis. Med Hypotheses 2011;77:185-7.
• Bratel J, Hakeberg M. Anamnestic findings from patients with recurrent aphthous stomatitis. Swed Dent J 2014;38:143-9.
• Balan U, Gonsalves N, Jose M, Girish KL. Symptomatic changes of oral mucosa during normal hormonal turnover in healthy young menstruating women. J Contemp Dent Pract 2012;13:178-81.
• McCullough MJ, Abdel-Hafeth S, Scully C. Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices? J Oral Pathol Med 2007;36:615-20.
• Tarakji B, Baroudi K, Kharma Y. The effect of dietary habits on the development of the recurrent aphthous stomatitis Niger Med J 2012;53:9–11.
• Wray D, Ferguson MM, Mason DK, Hutcheon AW, Dagg JH. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;31:490-3.
• Otan Özden F, Özden B, Tunga U. Tekrarlayan aftöz ülserasyonlar ve tedavisinde güncel yaklaşımlar. Cumhuriyet Üniv Diş Hek Fak Derg 2008;11:118-25.
• Najafi S, Yousefi H, Mohammadzadeh M, Bidoki AZ, Firouze Moqadam I, Farhadi E, et al. Association study of interleukin-1 family and interleukin-6 gene single nucleotide polymorphisms in recurrent aphthous stomatitis. Int J Immunogenet 2015;42:428-31.
• Avci E, Akarslan ZZ, Erten H, Coskun-Cevher S. Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers. Braz J Med Biol Res 2014;47:355-60.
• McCartan BE, Lamey PJ, Wallace AM. Salivary cortisol and anxiety in recurrent aphthous stomatitis. J Oral Pathol Med 1996;25:357-9.
• Karasneh JA, Bani-Hani ME, Alkhateeb AM, Hassan AF, Thornhill MH. Association of MMP but not TIMP-1 gene polymorphisms with recurrent aphthous stomatitis. Oral Dis 2014;20:693-9.
• Safadi RA. Prevalence of recurrent aphthous ulceration in Jordanian dental patients. BMC Oral Health 2009;9:31.
• Patil S, Reddy SN, Maheshwari S, Khandelwal S, Shruthi D, Doni B. Prevalence of recurrent aphthous ulceration in the Indian Population. J Clin Exp Dent 2014;1:6:e36-40.
• Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 2008;46:198-206.
• Erdoğan FG, Çakır GA, Gürler A, Elhan A. Aftların beslenme ve bazı kişisel değişkenlerle ilişkisinin değerlendirilmesi. Türkderm-Deri Hastalıkları ve Frengi Arşivi Derg 2009;43:107-11.
• Abdullah MJ. Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City. J Clin Exp Dent 2013;5:e89-94.
• Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States school children: 1986-87. Community Dent Oral Epidemiol 1994;22:243-53.
• Uysal MA, Kadakal F, Karşidağ C, Bayram NG, Uysal O, Yilmaz V. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004;52:115-21.
• Piper ME, McCarthy DE, Baker TB. Assessing tobacco dependence: A guide to measure evaluation and selection. Nicotine Tobacco Res 2006;8:339–51.
• de Meneses-Gaya IC, Zuardi AW, Loureiro SR, Crippa JA. Psychometric properties of the Fagerstrom Test for Nicotine Dependence. J Bras Pneumol 2009;35:73–82.
• Etter JF, Duc TV, Perneger TV. Validity of the Fagerström test for nicotine dependence and of the Heaviness of Smoking Index among relatively light smokers. Addiction 1999;94:269-81.
• Jacobi J, Jang JJ, Sundram U, Dayoub H, Fajardo LF, Cooke JP. Nicotine accelerates angiogenesis and wound healing in genetically diabetic mice. Am J Pathol 2002;161:97–104.
• Marakoğlu K, Sezer RE, Toker HC, Marakoğlu I. The recurrent aphthous stomatitis frequency in the smoking cessation people. Clin Oral Investig 2007;11:149–53.
• Ussher M, West R, Steptoe A, McEwen A. Increase in common cold symptoms and mouth ulcers following smoking cessation. Tob Control 2003;12:86–8.
• Mohamed S, Janakiram C. Recurrent aphthous ulcers among tobacco users- hospital based study. J Clin Diagn Res 2014;8: ZC64–LC66.
• Köybaşı S, Parlak AH. Tekrarlayıcı aftöz stomatit. Türkiye Klinikleri J Med Sci 2006;26:319-6.
• Karasneh J, Bani-Hani M, Alkhateeb A, Hassan A, Alzoubi F, Thornhill M. TLR2, TLR4 and CD86 gene polymorphisms in recurrent aphthous stomatitis. J Oral Pathol Med 2015;44:857-63.
• Karasneh JA, Darwazeh AM, Hassan AF, Thornhill M. Association between recurrent aphthous stomatitis and inheritance of a single nucleotide polymorphism of the NOS2 gene encoding inducible nitric oxide synthase. J Oral Pathol Med 2011;40:715-20.
• 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 1992;74:455-8.
• Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology, 3rd edn. St. Louis, MO: Saunders Elsevier; 2009, p. 332.
• Scully C, de Almeida OP, Bagan J, Dios PD, Taylor AM. Oral Medicine and Pathology at a Glance, 1st edn. West Sussex, UK: Wiley Blackwell; 2010, p. 56.
• Günhan Ö. Oral ve Maksillofasiyal Patoloji, 1. baskı. Ankara: Atlas Kitapçılık; 2001, s. 60.