Correlation between distribution of Helicobacter Pylori in oral cavity and chronic stomach conditions

Abstract

In this study, the colonization and distribution of Helicobacter pylori (Hp) in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases. Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp. Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques, gargles and dorsal mucosa were tested for Hp. The 96 patients were treated by bismuth triple therapy and among them, 52 subjects were additionally given periodontal initial therapy. The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment. The results showed that the detection rates of oral specimens were in the order of dental plaques (82.3%), gargles (51.1%) and scrapings of dorsal mucosa of tongue (37.5%). One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment, the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone (62.8% vs. 32.4%, P<0. 05). Moreover, the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy. We are led to conclude that Hp is present at various parts of oral cavity, oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.

A Prospective Study of Periodontal Disease and Risk of Gastric and Duodenal Ulcer in Male Health Professionals

“…28, 29, 30, 31, 32, 33 Adding periodontal treatment to standard triple antibiotic therapy also increased the effectiveness of gastric H. pylori eradication in studies of a general population cohort and of patients with chronic gastric illness. 34, 35 However, periodontal disease's association with gastric and duodenal ulcer may be related to mechanisms other than H. pylori colonization, as our data showed similar associations between periodontal disease and risk of H. pylori -positive and H. pylori -negative ulcers. One hypothesis is that oral microbiota, which have been associated with the impaired healing of periodontal lesions, 36, 37, 38, 39 may also be a source of chronic inflammation and impaired wound healing of gastrointestinal tract mucosa.…”

Oral Helicobacter pylori: Interactions with host and microbial flora of the oral cavity

“…Gao et al determined the effect of triple therapy (systemic therapy) and triple therapy combined with oral treatment, on the eradication rate of gastric H. pylori. 15 Combination therapy proved to be more effective, as one year after the end of treatment the incidence of these bacteria was twice as low (32.4%) as compared to the exclusive use of systemic therapy (62.8%). A similar relationship, showing an increased degree of H. pylori eradication after combination therapy, has been demonstrated in the meta-analyzes of Ren et al 56 and Bouziane et al 57 It was found that the relative chance of gastric H. pylori recurrence in patients who underwent oral and gastric therapy was reduced by 63%.…”

“…Other regions include the tonsils and dorsal mucosa of the tongue. 15,37 Many studies based on genetic or serological tests in H. pylori detection have shown the presence of this bacterium in the oral cavity or stomach, while the number of studies demonstrating the effective isolation of this microbe from the oral environment is still very low. Hirsch et al 23 successfully managed to isolate live H. pylori from samples taken from dental canals.…”

“…8,12 In many scientific studies, it is also suggested that the oral cavity may be a reservoir site for Gram-negative, microaerophilic Helicobacter pylori. 5,[13][14][15][16][17] Colonization of the oral cavity by H. pylori H. pylori infections occur most often in childhood, and clinical symptoms may develop over many years. This microorganism inhabits the gastric mucosa, where it is able to survive despite the therapy used.…”

Oral Cavity and Systemic Diseases—Helicobacter Pyloriand Dentistry

“…Analysis of these data suggests that periodontal treatment in combination with systemic therapy could be a promising approach to increase the efficacy of the treatment and to decrease the risk of infection recurrence (10). Based on the literature data and on our experience we recommend:…”