Management of Recurrent Aphthous Stomatitis: An Indian Expert Consensus

Area of Science:

• Oral Medicine
• Immunology
• General Practice

Background:

• Recurrent aphthous stomatitis (RAS) presents as painful oral ulcers with a highly variable prevalence (2-78%).
• The etiology of RAS is idiopathic and multifactorial, with current management hindered by a lack of established guidelines.
• Existing literature reveals significant gaps in the assessment and therapeutic approaches for RAS.

Purpose of the Study:

• To establish an Indian expert consensus for the diagnosis and management of Recurrent Aphthous Stomatitis (RAS).

Main Methods:

• Experts from Otorhinolaryngology, Oral Medicine/Dentistry, and Internal Medicine convened for in-person and online discussions.
• Evidence-based literature review and clinical practice insights informed the development of consensus recommendations.
• Consensus criteria for RAS definition and diagnostic workup were established.

Main Results:

• The prevalence of RAS in India is estimated to be between 2% and 5%.
• A diagnosis of RAS is proposed for individuals experiencing three or more recurrences of aphthous ulcers annually.
• Recommended investigations include complete blood count, serum vitamin B12, and iron studies.

Conclusions:

• The primary treatment goals for RAS are pain reduction, accelerated healing, decreased recurrence rates, and enhanced quality of life.
• Treatment strategies involve selecting topical and/or systemic agents based on ulcer severity, frequency, and patient history.
• This consensus aims to standardize RAS diagnosis and treatment, aiding healthcare providers in clinical decision-making.