Recurrent aphthous stomatitis (RAS), is characterized by recurrent,
ulcerative oral lesions which are often painful, single or multiple,
round or ovoid ulcers, present during childhood or adolescence and
recurs for variable periods of time. Discomfort in patients with RAS is
relatively high. The patients' life quality is affected by painfulness
of these mucosal lesions.The presence of ulcerations increase the flow
of saliva, and interfere with eating, drinking and speaking. Since the
etiology of RAS is unknown, many patients are receiving medication only
to relieve pain. RAS patients with anemia and lower hemoglobin levels
have reduced capacity of the blood to carry oxygen to oral mucosa,
finally resulting in atrophy of oral mucosa. Atrophic oral epithelium in
hematinic deficient patients may explain why some patients with
deficiencies of hematinics are prone to have RAS.The measurements of
vitamin B12 metabolites such as MMA and Hcy have been shown to be more
sensitive in the diagnosis of vitamin B12 deficiency measurement of
serum B12 levels alone which is one of the etiological factor in RAS.