Effects of eradication of Helicobacter pylori on oral malodor and the oral environment: a single-center observational study

Gastric Helicobacter pylori infection does not contribute to extraoral halitosis and its eradication cannot achieve substantial reduction of halitosis

Background

Some researchers have suggested that Helicobacter pylori (H. pylori) infection is attributed to extraoral halitosis. However, this viewpoint is increasingly challenged by clinical practice. This study was conducted with the aim of investigating changes of extraoral halitosis before and after H. pylori eradication.

Materials and Methods

Data of patients who had H. pylori infection and extraoral halitosis were retrospectively collected. H. pylori infection was diagnosed by positive 13C urea breath test (UBT). Extraoral halitosis was diagnosed by organoleptic score (OLS) ≥2 in nose breath. A 14‐day bismuth‐based quadruple therapy was administered for H. pylori eradication. Extraoral halitosis was examined before eradication (T1), on the first day after eradication (T2), 1 month after eradication (T3), and 3 months after eradication (T4). Eradication effect was checked by UBT at T3.

Results

A total of 100 patients were included. Eradication was successful in 74 out of 100 (74%) patients (success group) and failed in 26 out of 100 (26%) patients (failure group). 32 out of 74 (43.24%) patients in success group and 10 out of 26 (38.46%) patients in failure group had reduced halitosis at T2, 9 out of 74 (12.16%) patients in success group and 2 out 26 (7.69%) patients in failure group had relapsed halitosis at T3, and 23 out of 74 (31.08%) patients in success group and 8 out of 26 (30.77%) patients in failure group had relapsed halitosis at T4, without significant difference between groups at any time (p = 0.918, p = 0.808, and p = 0.808 respectively).

Conclusions

Helicobacter pylori infection does not contribute to extraoral halitosis. H. pylori eradication can achieve sustained but slight reduction of extraoral halitosis, probably due to its antibiotic effects on the gut microbiota rather than H. pylori.

Assessment of the Possible Correlation between the Presence of Helicobacter Pylori Infection and Hairy Tongue Lesion in a Group of Patients in Syria: A Cross-Sectional and Pilot Study

BACKGROUND

This study aimed to evaluate the correlation between the presence of hairy tongue and H. pylori infection in patients referring to their blood test based on the serum levels of anti-H pylori IgG antibodies.

METHODS

This cross-sectional study was conducted in the Department of Oral Medicine, University of Damascus Dental School, between February 2021 and January 2022. The sample size of 40 patients (23 males, 17 females), whose ages ranged from 20-79 years with a mean age of 41.5 ± 12 years, was calculated using the G*power 3.1.3, with a statistical power of 80% and a significance level of 0.05. The hairy tongue index was assessed by a visual method based on observing the dorsum tongue appearance. Then, a blood test was performed to detect the presence of H. pylori by Immulite 2000 XPi. Statistical analysis was performed using SPSS software 22.0, Chi-square.

RESULTS

The prevalence of hairy tongue was higher among males (75%) as compared to females (25%) and was found to be statistically significant (p = 0.026). The hairy tongue lesions were found to be least in the 20-39 age group and most prevalent in the 40-59 age group, without statistically significant correlation. H. pylori infection was detected positive in 70% and negative in 30% of hairy tongue patients, compared to the control group, where the rates were 15% and 85%, respectively, with a statistically significant correlation between infection with H. pylori and hairy tongue (p = 0.001).

CONCLUSION

Our results strongly suggest that the hairy tongue might be considered an indicator of H. pylori infection.

Analysis of oral microbiota alterations induced by Helicobacter pylori infection and vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication

BACKGROUND

The oral cavity is considered a potential reservoir of Helicobacter pylori (H. pylori), and the imbalance of oral microbiota directly reflects the health of the host. We aimed to explore the relationship among oral microbiota, H. pylori infection, and vonoprazan-amoxicillin (VA) dual therapy for H. pylori eradication.

METHODS

Helicobacter pylori-positive patients were randomized into low- or high-dose VA dual therapy (i.e., amoxicillin 1 g b.i.d. or t.i.d. and vonoprazan 20 mg b.i.d) for 7 or 10 days. H. pylori-negative patients served as normal controls. Saliva samples were collected from 41 H. pylori-positive patients and 13 H. pylori-negative patients. The oral microbiota was analyzed by 16S rRNA gene sequencing, followed by bioinformatics analysis.

RESULTS

Helicobacter pylori-positive patients had higher richness and diversity and better evenness of oral microbiota than normal controls. Beta diversity analysis estimated by Bray-Curtis or weighted UniFrac showed distinct clustering between H. pylori-positive patients and normal controls. The number of bacterial interactions was reduced in H. pylori-positive patients compared with that in negative patients. Forty-one patients evaluated before and after successful H. pylori eradication were divided into low (L-VA) and high dose (H-VA) amoxicillin dose groups. The alpha and beta diversity of the oral microbiota between L-VA and H-VA patients exhibited no differences at the three time points (before eradication, after eradication, and at confirmation of H. pylori infection cure).

CONCLUSION

Helicobacter pylori infection could alter the diversity, composition, and bacterial interactions of the oral microbiota. Both L-VA and H-VA dual therapy showed minimal influence on the oral microbiota.