Caspian Journal of Internal Medicine

Background: Aphthous lesions are common oral diseases that can affect the quality of life, especially in students, and are frequently triggered by factors such as stress. This study aimed to assess the global prevalence of recurrent aphthous stomatitis (RAS) among students.
Methods: This systematic review analyzed relevant evidence from international databases, including Scopus, PubMed/Medline, Web of Science, Embase, and Google Scholar, covering data from the earliest available records up to February 2025. Heterogeneity was assessed using Cochran's Q test and the I² statistic. Subgroup analyses were conducted based on gender, measurement tools, and target population, while meta-regression analysis was performed considering the study year.
Results: A total of 614 studies were reviewed, of which 28 met the inclusion criteria. Based on the random-effects model, the overall prevalence of RAS among the target population of students (both school and university students) was estimated to be 0.14 (95% CI, 0.06–0.24). The prevalence among school students was 0.12 (95% CI, 0.02–0.28), while among university students it was 0.15 (95% CI, 0.05–0.29). Furthermore, the prevalence of RAS was reported as 0.18 (95% CI, 0.05–0.36) in females and 0.10 (95% CI, 0.04–0.19) in males. Although the prevalence appeared to decrease over time, this reduction was not statistically significant (Reg Coef = -0.13, p = 0.115).
Conclusions: This study estimates the global prevalence of RAS among students to be 14%. The findings highlight the need for standardized strategies for the diagnosis and management of oral aphthous lesions in schools and universities.