Daily multivitamins did not reduce risk of mouth ulcers


Recurrent aphthous stomatitis (RAS), is one of the most common oral mucosal diseases. Minor RAS is the most common form of the disease.  The exact cause of RAS is still unknown and genetics, vitamin deficiencies, trauma, and immune dysfunction have been cited as possible causes.  The aim of this study was to see whether  a daily multivitamin supplement had any effect on the incidence and duration of RAS episodes over a 12-month period.

What did they do

160 adults who had a validated history of at least three episodes of idiopathic minor RAS within the previous 12 months were randomised to receive either , a once-daily multivitamin containing 100 percent of the U.S. reference daily intake (RDI) of essential vitamins (n = 83),   or  a once-daily placebo for up to 365 days (n = 77)

 The study protocol is available on line

 What did they find

There was no significant difference in the mean number of new RAS episodes between the two groups

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There were also no difference in relation to mouth pain, normalcy of diet or compliance with the study medication regimen.

They concluded

Daily multivitamin supplementation, with the RDI of essential vitamins, did not result in a reduction in the number or duration of RAS episodes. Clinicians should not recommend multi-vitamin supplementation routinely as prophylaxis for RAS

Lalla RV, Choquette LE, Feinn RS, Zawistowski H, Latortue MC, Kelly ET, Baccaglini L. Multivitamin therapy for recurrent aphthous stomatitis: A randomized, double-masked, placebo-controlled trial. J Am Dent Assoc. 2012 Apr;143(4):370-6. PubMed PMID: 22467697.


Only the abstract of this study was available to the Elf  for assessment but we have previously  reported on a  previous publication from this study which found that stress may be involved in the initiation of new RAS episodes. The study ran for one year and not all 160 completed the trial  with a total drop out of just under 30% which may have an impact on the findings.

For more information on vitamins and health visit NHS Choices

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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