Polymicrobial interactions of Helicobacter pylori and its role in the process of oral diseases

Abstract

Objective: Helicobacter pylori (H. pylori) infection affects approximately 50% of the global population. The predominant route of H. pylori transmission is through the oral pathway, making the oral cavity highly significant in its infection. This review focuses on the relationship between H. pylori and oral diseases, the influence of H. pylori infection on the oral microbiota, and the potential mechanisms involving certain oral pathogens.

Method: To identify relevant studies, we conducted searches in PubMed, Google Scholar using keywords such as "Helicobacter pylori," "oral diseases, " "oral microorganisms, " without any date restrictions. The retrieved publications were subject to a review.

Results: H. pylori infection is positively correlated with the occurrence of various oral diseases, such as dental caries, periodontitis, and oral lichen planus. H. pylori may affect the oral microbiota through various mechanisms, and there exists an interactive relationship between H. pylori and oral bacteria, including Streptococcus, Porphyromonas gingivalis (P. gingivalis), and Candida albicans (C. albicans).

Conclusions: H. pylori infection has a close relationship with certain oral diseases. H. pylori modulates oral microflora diversity and structure, while eradication therapy and medications have varying impacts on oral microbiota.

Keywords: Helicobacter pylori; eradication therapy; interaction; oral diseases; oral microbiology.

Figure 1.

Oral H. pylori infection has been associated with an elevated risk of periodontitis, dental caries, and other oral pathologies, such as OLP and RAS, potentially exacerbating their severity and influencing treatment outcomes. The association with OSCC remains contentious, although it may be associated with a less favorable prognosis. The eradication of H. pylori could potentially ameliorate symptoms in RAS. OLP, oral lichen planus; RAS, recurrent aphthous stomatitis; OSCC, oral squamous cell carcinoma.

Figure 2.

H. pylori interacts with oral microorganisms, which may influence the pathogenicity and ecological balance within the oral cavity. The bidirectional interaction between H. pylori and Streptococci influences the spatial distribution of H. pylori, with Streptococci modulating its growth and inducing a coccoid morphological transition. In turn, H. pylori perturbs the homeostasis of the dental plaque microbiota. H. pylori can modulate the virulence of P. gingivalis, with virulence factor genes of P. gingivalis detected in H. pylori-positive oral samples. P. gingivalis can co-aggregate with H. pylori. C. albicans may form a symbiotic relationship with H. pylori. Adverse conditions may facilitate the entry of H. pylori into C. albicans..