title: Can eradication rate of gastric Helicobacter pylori be improved by killing oral Helicobacter pylori?
abstract: OBJECTIVE
  To evaluate the influence of oral Helicobacter pylori (H. pylori) on the success of eradication therapy against gastric H. pylori.
  
  
  METHODS
  A total of 391 patients with dyspepsia were examined for H. pylori using the saliva H. pylori antigen test (HPS), ¹³C-urea breath test (UBT), gastroscopy, and gastric mucosal histopathological detection. Another 40 volunteers without discomfort were subjected to HPS and ¹³C-UBT, and served as the control group. The 233 patients who were (¹³C-UBT+ were enrolled in this study and divided into 4 groups. Patients who were HPS- and ¹³C-UBT+ (n = 53) received triple therapy alone. Those who were both HPS+ and ¹³C-UBT+ (n = 180) were randomly divided into 3 groups: (1) the O+G+t group which received triple therapy alone (n = 53); (2) the O+G+tm group which received both triple therapy and mouthrinse treatment (n = 65); and (3) the O+G+tmp group which received triple therapy, mouthrinse, and periodontal treatment (n = 62). The HPS and ¹³C-UBT were continued for 4 wk after completion of treatment, and the eradication rate of gastric H. pylori and the prevalence of oral H. pylori in the 4 groups were then compared.
  
  
  RESULTS
  The eradication rates of gastric H. pylori in the O-G+t group, the O+G+tm group, and the O+G+tmp group were 93.3%, 90.0%, and 94.7% respectively; all of these rates were higher than that of the O+G+t group (78.4%) [O-G+t group vs O+G+t group (P = 0.039); O+G+tm group vs O+G+t group (P = 0.092); O+G+tmp group vs O+G+t group (P = 0.012); O+G+tm group vs O-G+t group (P = 0.546); O+G+tmp group vs O-G+t group (P = 0.765); O+G+tm group vs O+G+tmp group (P = 0.924)]. The eradication of gastric H. pylori was significantly improved using the combination of triple therapy, mouthrinse, and periodontal treatment. The eradication rates of gastric H. pylori in the peptic ulcer group, chronic atrophic gastritis group and control group were higher than in the duodenitis group and the superficial gastritis group. The prevalence rates of oral H. pylori in the O-G+t group, O+G+t group, O+G+tm group and O+G+tmp group following treatment were 0%, 76.5%, 53.3%, and 50.9%, respectively [O-G+t group vs O+G+t group (P < 0.0001); O+G+tm group vs O+G+t group (P = 0.011); O+G+tmp group vs O+G+t group (P = 0.006); O+G+tm group vs O-G+t group (P < 0.0001); O+G+tmp group vs O-G+t group (P < 0.0001); O+G+tm group vs the O+G+tmp group (P = 0.790)]. Both mouthrinse and periodontal treatment significantly reduced the prevalence of oral H. pylori.
  
  
  CONCLUSIONS
  Mouthrinse treatment alone or combined with periodontal treatment can, to some extent, reduce the prevalence of oral H. pylori and improve the eradication rate of gastric H. pylori.
authors.affiliation: Han-Yi Song, Yan Li, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
authors.forename: Han-Yi
authors.initials: HY
authors.lastname: Song
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000302:isolation & purification; D001706:Biopsy; D001944:Breath Tests; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D003728:Dental Calculus / Q000382:microbiology / Q000628:therapy*; D003773:Dental Plaque / Q000382:microbiology / Q000628:therapy*; D003777:Dental Prophylaxis; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012463:Saliva / Q000382:microbiology; D013270:Stomach / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D000942:Antigens, Bacterial; D009067:Mouthwashes; D054328:Proton Pump Inhibitors
keywords: Dental plaque; Eradication; Helicobacter pylori; Mouthrinse; Periodontal