Published online Jan 14, 2016. doi: 10.3748/wjg.v22.i2.641
Peer-review started: April 15, 2015
First decision: May 18, 2015
Revised: August 4, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: January 14, 2016
Processing time: 268 Days and 15.3 Hours
Over the past several years, the severity of Helicobacter pylori (H. pylori) infections has not significantly diminished. After successful eradication, the annual H. pylori recurrence rate is approximately 13% due to oral H. pylori infection. Established clinical diagnostic techniques do not identify an oral etiologic basis of H. pylori prior to gastric infection. There has been disagreement as to whether oral infection of H. pylori exists or not, with no definite conclusion. In medical practice, negative results with the urea breath test suggest that the stomach infection of H. pylori is cured in these patients. In fact, patients can present negative urea breath test results and yet exhibit H. pylori infection due to oral infection. The present paper provides evidence that H. pylori oral infection is nonetheless present, and the oral cavity represents a secondary site for H. pylori colonization.
Core tip: Recent studies designed to test the role of the oral cavity as a significant reservoir for Helicobacter pylori (H. pylori) and that used more appropriate methodologies have produced contrasting facts with respect to the existence of oral H. pylori. In this article, the author presents evidence supporting the oral cavity as a second colonized site for H. pylori, besides primarily residing in the stomach, which plays a significant role in H. pylori diagnosis, transmission, and treatment. Additionally, this article introduces new technology for the diagnosis, cell culture, and treatment of oral H. pylori.