Association between Helicobacter pylori gastritis and dental diseases: A cross‐sectional, hospital‐based study in Eastern Saudi Arabia

Abstract

Background There is inconsistent evidence about the association between Helicobacter pylori (H. pylori) and dental diseases with possible effect of environmental factors. The aims of the study were to assess (1) the association between gastric and oral H. pylori colonization and (2) the association between oral colonization of H. pylori and dental diseases. Methods A cross‐sectional study was conducted in King Fahad University hospital in Khobar, Eastern Saudi Arabia in 2017. Patients admitted to the Endoscopy Unit were recruited and clinically examined for plaque, decayed teeth (D), filled teeth (F), missing teeth (M), periodontal pocket depth (PPD), attachment loss (AL), and gingival bleeding in addition to assessing their age, gender, education, tooth brushing, flossing, and tobacco use with a questionnaire. Pooled dental plaque samples were collected and analyzed using nested polymerase chain reaction PCR to detect oral H. pylori. Gastroscopy was used to extract biopsies to assess gastritis and the presence of gastric H. pylori using Giemsa stain. Regression analysis was used to assess differences between patients with and without gastritis, oral H. pylori and gastric H. pylori in the percentage of sites with gingival bleeding, PPD, CAL, D, M, and F with adjustment for confounders. Results One hundred twenty patients were included. Most of them brushed daily (82.6%) and had university education (45.7%). Of these, 34.2% had gastric H. pylori and 5% had oral H. pylori. No significant association was observed between the percentage of sites with gingival bleeding, mean PPD, AL, F, and either gastritis, the presence of oral or gastric H. pylori. Patients with gastritis had significantly higher number of D and M than patients without gastritis (P = 0.03). Conclusions In this study, the presence of gastric and oral H. pylori in patients with good oral hygiene and moderate socioeconomic status is not significantly associated with periodontal diseases. Patients with gastritis tend to have a higher number of decayed and missing teeth.

Possible Association of Periodontal Diseases With Helicobacter pylori Gastric Infection: A Systematic Review and Meta-Analysis

“…Today, many modifications of PCR technology have been developed to increase the sensibility of detection, even to increase sensitivity to 100% ( 61 ). In recent years, a new PCR system has been developed, which uses primer sets specific to 48 H. pylori strains in order to increase the diagnostic accuracy of PCR in the oral cavity; however, despite being a highly sensitive method, certain authors have drawn attention to its poor ability to detect small amounts of bacteria, depending on the specificity and sensitivity of the primer used, for example, primers related to bacterial urease activity often prove to be a confounding factor ( 62 ). Amiri et al ( 63 ) described a highly specific and sensitive DNA amplification method for the detection of H. pylori in dental plaque samples, showing that it had a higher detection rate than PCR by 66.67 and 44%, respectively.…”

Association among Helicobacter pylori Infection, Tooth Loss, and Heavy Medal Exposure in a Chinese Rural Population

“…Finally, we analyzed the relationship between H. pylori infection and dental problems in people exposed to Pb and Cd, and found that the greater the numbers of FT and MFT are, the stronger the correlation between FT, MFT, and H. pylori infection is. Previous studies have not reached a consistent conclusion on the relationship between H. pylori infection and dental problems [17,37,40,41]. For example, Zahedi et al reported an association between gastric infection with H. pylori and the The Decayed, Missing, and Filled Teeth (DMFT) index [41].…”

“…Conflicting results have been reported on the association between dental problems, including missing teeth (MT), filled teeth (FT), missing or filled teeth (MFT), and H. pylori infection. Alag et al found that the number of MT does not seem to be associated with gastric or oral H pylori positivity [17]. In contrast, Shimoyama et al found that H. pylori infection was associated with a decreased risk of tooth loss in healthy Japanese men [18].…”

Higher Risk of Gastric Helicobacter pylori Infection in Patients with Periodontitis: A Nationwide Population-Based Retrospective Cohort Study in Taiwan

“…These findings conclude that developing new therapies and reducing periodontitis might decrease the risk of developing gastric Hp -related diseases. In contrast to these studies, one clinical-based study in Saudi Arabia, performed on 120 participants with good oral hygiene practices, showed that there was no significant association between gastric or oral Hp infection and periodontal disease [ 36 ]. In the present study, it is worth mentioning that periodontitis, with or without comorbidity, increases the risk of gastric Hp and, thereby, might be involved in the development and progression of many gastro-intestinal-related pathologies.…”