Helicobacter Pylori and Periodontal diseases: An update and proposal of a multidisciplinary clinical protocol


Helicobacter Pylori has been closely linked to chronic gastritis, peptic ulcers and increased risk of gastric carcinoma. Oral cavity, in particular dental plaque in periodontal pockets, may be a possible reservoir harboring H. Pylori, and may therefore be involved in the gastric reinfection by the bacterium, even after triple therapy regimen. This report is an update of scientific data showing the potential localization of H. Pylori in the oral cavity of periodontitis patients. A multidisciplinary clinical protocol combining full-mouth disinfection and triple therapy is also suggested. This protocol could permit to enhance oral H. Pylori eradication.

Share and Cite:

Marbaix, S. , Soueidan, A. , Romani, M. , Campard, G. , Amador, G. and Badran, Z. (2013) Helicobacter Pylori and Periodontal diseases: An update and proposal of a multidisciplinary clinical protocol. Open Journal of Stomatology, 3, 318-322. doi: 10.4236/ojst.2013.36053.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Gebara, E.C., Faria, C.M., Pannuti, C., Chehter, L., Mayer, M.P. and Lima, L.A. (2006) Persistence of Helicobacter pylori in the oral cavity after systemic eradication therapy. Journal of Clinical Periodontology, 33, 329-333. doi:10.1111/j.1600-051X.2006.00915.x
[2] Souto, R. and Colombo, A.P. (2008) Detection of Helicobacter pylori by polymerase chain reaction in the subgingival biofilm and saliva of non-dyspeptic periodontal patients. Journal of Periodontology, 79, 97-103. doi:10.1902/jop.2008.070241
[3] Sambashivaiah, S., Bilichodmath, S., Nanjaiah, N. and Kulal, R. (2011) Helicobacter pylori in periodontal pockets of chronic periodontitis patients with and without type II diabetes mellitus: A randomized controlled trial.
[4] Bago, I., Plecko, V., Aurer, A., Majstorovic, K. and Budimir, A. (2011) The effectiveness of systemic eradication therapy against oral Helicobacter pylori. Journal of Oral Pathology & Medicine, 40, 428-432. doi:10.1111/j.1600-0714.2010.00989.x
[5] Zaric, S., Bojic, B., Jankovic, L., Dapcevic, B., Popovic B., Cakic, S. and Milasin, J. (2009) Periodontal therapy improves gastric Helicobacter pylori eradication. Journal of Dental Research, 88, 946-950. doi:10.1177/0022034509344559
[6] Jia, C.L., Jiang, G.S., Li, C.H. and Li, C.R. (2009) Effect of dental plaque control on infection of Helicobacter pylori in gastric mucosa. Journal of Periodontology, 80, 1606-1609. doi:10.1902/jop.2009.090029
[7] Dye, B.A., Kruszon-Moran, D. and McQuillan, G. (2002) The relationship between periodontal disease attributes and Helicobacter pylori infection among adults in the United States. The American Journal of Public Health, 92, 1809-1815. doi:10.2105/AJPH.92.11.1809
[8] Quirynen, M., Mongardini, C., de Soete, M., Pauwels, M., Coucke, W., van Eldere, J. and van Steenberghe, D. (2000) The role of chlorhexidine in the one-stage full-mouth disinfection treatment of patients with advanced adult periodontitis. Long-term clinical and microbiological observations. Journal of Clinical Periodontology, 27, 578-589. doi:10.1034/j.1600-051x.2000.027008578.x
[9] Quirynen, M., Mongardini, C., Pauwels, M., Bollen, C.M., Van Eldere, J. and van Steenberghe, D.(1999) One stage full-versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. II. Long-term impact on microbial load. Journal of Periodontology, 70, 646-656. doi:10.1902/jop.1999.70.6.646
[10] Aimetti, M., Romano, F., Guzzi, N. and Carnevale, G. (2012) Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: A randomized, placebo-controlled trial. Journal of Clinical Periodontology, 39, 284-294. doi:10.1111/j.1600-051X.2011.01795.x
[11] Cionca, N., Giannopoulou, C., Ugolotti, G. and Mombelli, A. (2009) Amoxicillin and metronidazole as an adjunct to full-mouth scaling and root planing of chronic periodontitis. Journal of Periodontology, 80, 364-371. doi:10.1902/jop.2009.080540
[12] Gomi, K., Yashima, A., Nagano, T., Kanazashi, M., Maeda, N. and Arai, T. (2007) Effects of full-mouth scaling and root planing in conjunction with systemically administered azithromycin. Journal of Periodontology, 78, 422-429. doi:10.1902/jop.2007.060247
[13] Al Asqah, M., Al Hamoudi, N., Anil, S., Al Jebreen, A. and Al-Hamoudi, W.K. (2009) Is the presence of Helicobacter pylori in dental plaque of patients with chronic periodontitis a risk factor for gastric infection? Canadian Journal of Gastroenterology, 23, 177-179.
[14] Gebara, E.C., Pannuti, C., Faria, C.M., Chehter, L., Mayer, M.P. and Lima, L.A. (2004) Prevalence of Helicobacter pylori detected by polymerase chain reaction in the oral cavity of periodontitis patients. Oral Microbiology and Immunology, 19, 277-280. doi:10.1111/j.1399-302X.2004.00153.x
[15] Riggio, M.P. and Lennon, A. (1999) Identification by PCR of Helicobacter pylori in subgingival plaque of adult periodontitis patients. Journal of Medical Microbiology, 48, 317-322. doi:10.1099/00222615-48-3-317
[16] Asikainen, S., Chen, C. and Slots, J. (1994) Absence of Helicobacter pylori in subgingival samples determined by polymerase chain reaction. Oral Microbiology and Immunology, 9, 318-320. doi:10.1111/j.1399-302X.1994.tb00079.x
[17] Silva, D.G., Stevens, R.H., Macedo, J.M., Albano, R.M., Falabella, M.E., Fischer, R.G., Veerman, E.C. and Tinoco, E.M. (2010) Presence of Helicobacter pylori in supragingival dental plaque of individuals with periodontal disease and upper gastric diseases. Archives of Oral Biology, 55, 896-901. doi:10.1016/j.archoralbio.2010.06.018
[18] Burgers, R., Schneider-Brachert, W., Reischl, U., Behr, A., Hiller, K.A., Lehn, N., Schmalz, G. and Ruhl, S. (2008) Helicobacter pylori in human oral cavity and stomach. European Journal of Oral Sciences, 116, 297-304. doi:10.1111/j.1600-0722.2008.00543.x
[19] Umeda, M., Kobayashi, H., Takeuchi, Y., Hayashi, J., Morotome-Hayashi, Y., Yano, K., Aoki, A., Ohkusa, T. and Ishikawa, I. (2003) High prevalence of Helicobacter pylori detected by PCR in the oral cavities of periodontitis patients. Journal of Periodontology, 74, 129-134. doi:10.1902/jop.2003.74.1.129
[20] Bielanski, W. (1999) Epidemiological study on Helicobacter pylori infection and extra gastroduodenal disorders in Polish population. Journal of Physiology and Pharmacology, 50, 723-733.
[21] Czesnikiewicz-Guzik, M., Bielanski, W., Guzik, T.J., Loster, B. and Konturek, S.J. (2005) Helicobacter pylori in the oral cavity and its implications for gastric infection, periodontal health, immunology and dyspepsia. Journal of Physiology and Pharmacology, 56, 77-89.
[22] Czesnikiewicz-Guzik, M., Karczewska, E., Bielanski, W., Guzik, T.J., Kapera, P., Targosz, A., Konturek, S.J. and Loster, B. (2004) Association of the presence of Helicobacter pylori in the oral cavity and in the stomach. Journal of Physiology and Pharmacology, 55, 105-115.
[23] Anand, P.S., Nandakumar, K. and Shenoy, K.T. (2006) Are dental plaque, poor oral hygiene, and periodontal disease associated with Helicobacter pylori infection? Journal of Periodontology, 77, 692-698. doi:10.1902/jop.2006.050163
[24] Berroteran, A., Perrone, M., Correnti, M., Cavazza, M.E., Tombazzi, C., Goncalvez, R. and Lecuna, V. (2002) Detection of Helicobacter pylori DNA in the oral cavity and gastroduodenal system of a Venezuelan population. Journal of Medical Microbiology, 51, 764-770.
[25] Hardo, P.G., Tugnait, A., Hassan, F., Lynch, D.A., West, A.P., Mapstone, N.P., Quirke, P., Chalmers, D.M., Kowolik, M.J. and Axon, A.T. (1995) Helicobacter pylori infection and dental care. Gut, 37, 44-46. doi:10.1136/gut.37.1.44
[26] Song, Q., Lange, T., Spahr, A., Adler, G. and Bode, G. (2000) Characteristic distribution pattern of Helicobacter pylori in dental plaque and saliva detected with nested PCR. Journal of Medical Microbiology, 49, 349-353.
[27] Czesnikiewicz-Guzik, M., Loster, B., Bielanski, W., Guzik, T.J., Konturek, P.C., Zapala, J. and Konturek, S.J. (2007) Implications of oral Helicobacter pylori for the outcome of its gastric eradication therapy. Journal of Clinical Gastroenterology, 41, 145-151. doi:10.1097/01.mcg.0000225654.85060.3d
[28] Gurbuz, A.K., Ozel, A.M., Yazgan, Y., Celik, M. and Yildirim, S. (2003) Oral colonization of Helicobacter pylori: Risk factors and response to eradication therapy. South African Medical Journal, 96, 244-247. doi:10.1097/01.SMJ.0000051069.50950.2B
[29] Pytko-Polonczyk, J., Konturek, S.J., Karczewska, E., Bielanski, W. and Kaczmarczyk-Stachowska, A. (1996) Oral cavity as permanent reservoir of Helicobacter pylori and potential source of reinfection. Journal of Physiology and Pharmacology, 47, 121-129.
[30] Zou, Q.H. and Li, R.Q. (2011) Helicobacter pylori in the oral cavity and gastric mucosa: a meta-analysis. Journal of Oral Pathology & Medicine, 40, 317-324. doi:10.1111/j.1600-0714.2011.01006.x
[31] Bouziane, A., Ahid, S., Abouqal, R. and Ennibi, O. (2012) Effect of periodontal therapy on prevention of gastric Helicobacter pylori recurrence: A systematic review and meta-analysis. Journal of Clinical Periodontology, 39, 1166-1173. doi:10.1111/jcpe.12015
[32] Tarullo, A., Tattoli, M. and Cagiano, R. (2001) Persistent eradication of Helicobacter pylori after systemic politherapy associated with periodontal pockets treatment with metronidazole and calcium sulphate. European Review for Medical and Pharmacological Sciences, 5, 127-129.
[33] Escobar, E.C., Chambrone, L., Pannut, C.M., Mayer, M.P.A. and Lima, l.A. (2013) Full mouth ultrasonic debridement in Helicobacter Pylori eradication from the oral cavity: A case series. Canadian Journal of Dental Hygiene, 47, 39.
[34] Sanz, M. and Teughels, W. (2008) Innovations in nonsurgical periodontal therapy: Consensus Report of the Sixth European Workshop on Periodontology. Journal of Clinical Periodontology, 35, 3-7. doi:10.1111/j.1600-051X.2008.01256.x
[35] Burrell, R.C. and Walters, J.D. (2008) Distribution of systemic clarithromycin to gingiva. Journal of Periodontology, 79, 1712-1718. doi:10.1902/jop.2008.080013
[36] Socransky, S.S. and Haffajee, A.D. (2002) Dental biofilms: Difficult therapeutic targets. Periodontology, 28, 12-55. doi:10.1034/j.1600-0757.2002.280102.x
[37] Herrera, D., Alonso, B., Leon, R., Roldan, S. and Sanz, M. (2008) Antimicrobial therapy in periodontitis: The use of systemic antimicrobials against the subgingival biofilm. Journal of Clinical Periodontology, 35, 45-66. doi:10.1111/j.1600-051X.2008.01260.x

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.