Dental implications of Helicobacter pylori

Helicobacter pylori infections of the stomach are common worldwide and may cause serious medical problems, ranging from gastritis and its sequelae to gastric carcinoma or lymphoma. Current studies indicate that H. pylori is present in dental plaque, although the number of organisms in individual samples is very low, and these numbers appear to vary from one site to another within the mouth. The presence of this organism in plaque may be intermittent, perhaps occurring as the result of gastroesophageal reflux. It is still unclear if the low numbers of H. pylori present in the mouths of most patients would be sufficient to serve as a source of infection or reinfection for gastric conditions. Whether dental plaque is a significant source for reinfection of the gastric mucosa among patients with fair to poor oral hygiene remains to be confirmed. It has been suggested that attempting to improve oral hygiene through standard periodontal procedures would be prudent as an ancillary measure to conventional ulcer therapy, especially in patients whose gastric infections have proven recalcitrant. H. pylori may also be a cofactor in the recurrence of aphthous ulceration, especially in patients sensitized through gastric colonization and mucosal attachment.