title: Is Helicobacter pylori resident or transient in the human oral cavity?
abstract: Helicobacter pylori colonizes the stomachs of at least half of the world's human population. The role of the oral cavity in this colonization is not clear and there are, to date, no comprehensive data that clearly demonstrate the isolation of this bacterium from the oral cavity. The aim of this study was to evaluate the prevalence of H. pylori in the oral cavity of 15 patients who tested positive for H. pylori. A comprehensive dental examination of all patients was conducted. Samples were taken from supragingival and subgingival plaque, saliva, periapical exudates and tongue swabs. All samples were taken before the application of antibiotics. A total of 163 oral samples were investigated by PCR using two different H. pylori-specific primer pairs. A PCR inhibition control using a modified plasmid was always included for the most specific primer pair. In addition, a culture technique was used to confirm PCR results. Despite a PCR detection limit of 10(2) bacteria ml(-1), out of 14 patients, H. pylori could not be detected in any of the samples taken. In one patient, H. pylori-positive PCR signals were obtained in two samples using only one primer pair. H. pylori could not be cultivated from these two PCR-positive samples; therefore, no correlation to oral colonization status could be established. This study challenges the misleading preconception that H. pylori resides in the human oral cavity and suggests that this bacterium should be considered transient and independent of the oral status. To date, positive PCR results for H. pylori in the oral cavity have been overestimated and not critically interpreted in literature.
authors.affiliation: Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Al-Ahmad
authors.affiliation: Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kürschner
authors.affiliation: Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Weckesser
authors.affiliation: Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wittmer
authors.affiliation: Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Rauberger
authors.affiliation: Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Jakob
authors.affiliation: Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Hellwig
authors.affiliation: Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kist
authors.affiliation: Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Waidner
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial