Vol. zyxwvutsrqp 64, No. 3, Summer 2004 zyxwvutsrq 151 Prevalence and Handedness Correlates of Recurrent Aphthous Stomatitis in the Turkish Population zy Yasin Cigek, DDS, PhD; Varol Canakqi, DDS, PhD; Mehmet Ozgoz, DDS; Umit Ertas, DDS, PhD; Ebru Canakqi, MD Abstract zyxwvutsrq Objectives: zyxwvutsrq The present study was designed to determine the relationship between recurrent aphthous stomatitis (RAS) and handedness, and to assess the prevalence of RAS in the Turkish population. Methods: The present study was conductedamong 1 zyxwvutsr 1,360 persons (5,705 males and 5,655 females) with a mean age of 30.4 years. A questionnaire focusing on handedness was administered to these patients. Handedness was assessed according to the Edinburgh Handed- ness Inventory. The diagnosis of RAS was made on the basis of clinical appear- ance, location, and the patient‘s health history. RAS information of patients was collected by means of a data form specifically designed for this study. Subjects were informed about RAS. We took anamneses and filled out the investigation forms. Apart from patients with registration of current aphthae (average point prevalence, APP), patients who had a past two-year history (self-reported two- year prevalence, SRTP) of the lesion were also included in this study. Data were analyzed using the chi-square and logistic regression tests. Results: Thepreva- lence of RAS (APP) was 2.7 percent and that of a history of RAS (SRTP) 22.8 percent. Thus, the total prevalence (APP+ SRTP), including present lesions and a two-year history (SRTP), was 25.5 percent. Adjusted results showed that females, left-handers, 10-30-year-olds, and nonsmokers were 1 .53, 7.69, 2.05, and 1.61 times more likely to have RAS (APP+SRTP) than males, right-handers, 3 1 -5O-year-olds, and smokers, respectively p zyxwv <. OOO 1). Conclusion: Thepresent study suggests that left-handednessappears to be a predictor factor for BAS. [J Public Health Dent 20O4;64(3):l51-56] Key Words:prevalence, recurrent aphthous ulcer, handedness, etiology. Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal pathologic conditions (1,2). During the past decades, many studies focused on prevalence and etiology of RAS (3-6). Because of the different study design and distinct charac- teristic of samples, the prevalence of RAS for the general population within these studies varied widely from 0.4 percent (3) to 66 percent (4), with a mean of 20 percent. It has been reported that the age and sex distribution of the subjects and type of population studied can influ- ence the prevalence of RAS (7-10). The condition was found to be slightly more common in females (9,ll). RAS may appear at any age, with the great- est frequency in young adults (9,ll). The increased prevalence of the dis- ease in certain populations may be at least partially associated with social class, tradition, as well as the genetic background of the population (12,13). Although many theories of the eti- ology of RAS exist, no single causative factor appears to exist (14). A number of authors make a distinction between etiology and predisposing factors (15- 17). The latter are important in deter- mining the prevalence, severity, and presentation of this disease. Of the predisposing factors, there is now evi- dence that immune responses may be involved in the pathogenesis of RAS, and other factors may precipitate or modulate the immune responses (14- 17). However, researchers have re- ported an association between left- handedness and immune disorders (e.g., asthma, autoimmune diseases, eczema, and allergic rhinitis) (18-21). To our knowledge, the influence of handedness on RAS has not been re- ported before in the scientific litera- ture, and the association between RAS and handedness is not clear. Also, we have not found any research about prevalence of RAS in the Turkish population. The present study was de- signed to determine the relationship between RAS and handedness, and to assess the prevalence of RAS in the Turkish population. Methods Over the last 6 months, 21,870 pa- tients have been registered in the Ataturk University Faculty of Den- tistry. Of these, 13,278 patients aged 10-50 years old were seeking treat- ment for various dental conditions. RAS information of patients was collected by means of a data form spe- cifically designed for zy this study. In ad- dition to personal information (age, sex, socioeconomic situation, educa- tion level, smoking, and alcohol zy use) about the patient, the form had ques- tions concerning the history, fre- quency, and distribution of RAS and triggering factors for RAS. Apart from patients with registration of current aphthae (average point prevalence, APP), patients who had a past two- year history (self-reported two-year prevalence, SRTP) of the lesion were also included in the present study. Anamneses of the subjects who were under the age of 15 years were ob- tained together with the patients’ par- ents. Written informed consent was obtained from patients and, for pa- tients aged <18 years old, the patients’ Send correspondence and reprint requests to Dr. Cicek, Atatiirk University, Faculty of Dentistry, Department of Periodontology, 25240 zyx Eaurum, Turkey. E-mail: ycicek@atauni.edu.tror yasincicek@tnn.net. Dr. V. Canakci, Ozgoz, and Ertas are with the Faculty of Dentistry; Dr. E. Canakci is with the the Faculty of Medicine, all at Atatiirk University, Erzurum. Manuscript received: 9/3/03; returned to authors for revision: 10/7/03; final version accepted for publication: 1/20/04.