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J Med Microbiol 57 (2008), 1553-1559; DOI: 10.1099/jmm.0.2008/003715-0
? 2008 Society for General Microbiology
ISSN 0022-2615

Detection of Helicobacter pylori DNA in the saliva of patients complaining of halitosis
Nao Suzuki, Masahiro Yoneda, Toru Naito, Tomoyuki Iwamoto, Yousuke Masuo, Kazuhiko Yamada,
Kazuhiro Hisama, Ichizo Okada and Takao Hirofuji
Section of General Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1,
Tamura, Sawara-ku, Fukuoka 814-0193, Japan

Correspondence
Nao Suzuki

Received May 21, 2008
Accepted August 5, 2008

Helicobacter pylori infection, which causes peptic ulcers and gastric cancer, is considered a possible
cause of halitosis. Recently, the oral cavity was identified as a possible H. pylori reservoir, particularly
in the presence of periodontal disease, which is a cause of halitosis. The purpose of this study was to
evaluate by PCR the prevalence of oral H. pylori in the saliva of subjects complaining of halitosis.
Samples were obtained from 326 non-dyspeptic subjects, comprising 251 subjects with actual malodour
and 75 subjects without halitosis. DNA was extracted from the samples, and the presence of H. pylori and
periodontopathic bacteria including Porphyromonas gingivalis, Treponema denticola and Prevotella
intermedia was examined by PCR. H. pylori was detected in 21 (6.4 %) of 326 samples.
The methyl mercaptan concentration and periodontal parameters including tooth mobility, periodontal
pocket depth (PPD) and occult blood in the saliva were significantly greater in the H. pylori-positive
subjects. Each of the periodontopathic bacteria was also detected at a significantly higher frequency in
the H. pylori-positive subjects. Among those patients with a PPD of 5 mm and a tongue coating score of 2,
no difference was observed in oral malodour levels between the H. pylori-positive and -negative subjects.
However, the presence of occult blood in the saliva and the prevalence of Prevotella intermedia were
significantly greater in the H. pylori-positive subjects. H. pylori was detected in 16 (15.7 %) of 102 subjects
with periodontitis, suggesting that progression of periodontal pocket and inflammation may favour
colonization by this species and that H. pylori infection may be indirectly associated with oral pathological
halitosis following periodontitis.

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Abbreviations: OLT, organoleptic test; PPD, periodontal pocket depth; VSC, volatile sulfur compound.