Dental risk factors associated with oral Helicobacter pylori infection: a cross-sectional study based on saliva antigen test.

Introduction: Besides stomach, the oral cavity is the second reservoir of Helicobacter pylori (H. pylori) that plays an important role in oral diseases and recurrent gastric infection. This study aimed to determine the risk factors of oral H. pylori infection for better human health.

Methodology: Saliva samples from 280 subjects who visited the dental clinics were collected for the H. pylori antigen test. The data regarding age, gender, residence, frequency of tooth brushing, presence of dental caries and/or periodontitis were reported for each participant. Stool antigen Helicobacter pylori test was used to detect gastric infection.

Results: The overall prevalence of H. pylori in oral cavity and stool were 40.4%; 95% CI [34.8-46.2], and 36.4%; 95% CI [31-42.2], respectively and were not statistically significant (p = 0.546). The differences of positive rates of H. pylori infection according to the presence of periodontitis (54.7% vs 30.1%, p < 0.001, OR; 95% CI: 2.8 (1.7-4.6)) and dental caries (47.1% vs 32%, p = 0.001, OR; 95% CI: 2.2 (1.3-3.5)) were statistically significant. Living in rural areas increases the risk of acquiring H. pylori infection compared with urban areas (46.9% vs 34.7%, p < 0.001, OR; 95% CI: 0.6 (0.4-1)).

Conclusions: The H. pylori antigen test on saliva could be used as evidence of gastric infection. Oral diseases including periodontal diseases and caries are important risk factors for H. pylori colonization, so the professional treatment of these diseases may reduce the rate of new and recurrent gastric infection by H. pylori.