Is vitamin D deficiency a risk factor for recurrent aphthous stomatitis? A systematic review and meta-analysis

Oral Dis. 2019 Sep 6. doi: 10.1111/odi.13189. Online ahead of print.


Objectives: A few studies have associated vitamin D deficiency with the occurrence of recurrent aphthous stomatitis (RAS). Hence, the aim of the present systematic review and meta-analysis is to explore such a potential association.

Methods: A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted in June 2019. The inclusion criteria were (a) observational studies that assessed the relationship between vitamin D and RAS, and (b) the outcome measures reported quantitative vitamin D levels. Studies without control groups, case series, case reports, experimental studies, letter to editors, reviews, were excluded. The random effects model was conducted for meta-analyses using RevMan 5.3 software.

Results: Five studies comprising 208 RAS patients and 241 healthy individuals were included. All studies except one reported significantly lower levels of vitamin D in RAS patients compared with the healthy individuals. The results of the pooled 5 studies revealed statistically significant lower levels of vitamin D in RAS patients (Mean Difference (MD) = -9.67 ng/ml, 95% CI = -15.68, -3.65; p ˂ .002).

Conclusion: The present meta-analysis suggests a significant association between low vitamin D levels and RAS. Further well-designed studies with adequate sample sizes are required to elucidate the role of vitamin D in pathogenesis of RAS.

Keywords: aphthous stomatitis; correlation; risk factor; vitamin D.

Publication types

  • Review