The Relationship Between Helicobacter pylori and Oral Health

Abstract

Helicobacter pylori (H. pylori) is a Gram (-) microaerophilic bacteria, the primary localization of which is the gastric mucosa. Low education level and socioeconomic status are among the reasons for the increase of H. pylori infections. In developed countries, the possibility of getting infected with this bacteria in childhood has almost disappeared. However, more than 80% of adults in poor countries are infected with H. pylori. H. pylori affects 50% of the world population. H. pylori was first isolated from dental plaque in 1989 by Krajden and Fuksa. Except for the gastrointestinal region, the presence of H. pylori in the gingival pocket, dental plaque and adenotonsillar region has been demonstrated by many studies. It is believed that the secondary reservoir of H. pylori which causes gastrointestinal infections and stomach cancers, may be the oral mucosa especially in recurrent and refractory infections. Oral H. pylori has been shown to be associated with oral hygiene and periodontal status. It has been reported that the recurrence rate of H. pylori infection is higher in the individual with poor oral hygiene and the suppression of H. pylori infection in the stomach may increase by improving oral hygiene. Currently, the treatment of H. pylori infection seems to be is successful in managing gastric infection. However, only systemic H. pylori eradication therapy has been reported to have little effect on oral H. pylori. In addition to the effect of gastric H. pylori treatment on the presence of oral H. pylori, periodontal treatment approaches also have effects on gastric H. pylori infection. For these reasons, it is important to define the role of dental plaque, saliva and periodontal disease in H. pylori infection. In this review, the relationship between H. pylori and periodontal status is presented under the guidance of accessible resources.

Helicobacter pylori ve Ağız Sağlığı İlişkisi

Abstract

Primer lokalizasyonu gastrik mukoza olan Helicobacter pylori (H. pylori) Gram (-), mikroaerofilik bir bakteridir. H. pylori ilk kez 1983’de Marshall ve Waren tarafından kronik gastritli bir hastanın mide mukozasından izole edilmiştir. H. pylori çocukluk çağında alınan bir bakteridir. Sosyoekonomik durum ve eğitim seviyesinin düşük olması, temiz su ve gıdaya erişememe H. pylori enfeksiyonlarının artış nedenleri arasındadır. Gelişmiş ülkelerde, çocukluk çağında H. pylori ile enfekte olma olasılığı hemen hemen ortadan kalkmıştır. Ancak fakir ülkelerde yetişkinlerin %80’den fazlası H. pylori ile enfektedir. H. pylori dünya nüfusunun %50’sini etkilemektedir. H. pylori dental plaktan 1989 yılında ilk olarak Krajden ve Fuksa tarafından izole edilmiştir. H. pylori’nin gastrointestinal bölge dışında dişeti cebi, dental plak ve adenotonsiller bölgedeki varlığı çeşitli çalışmalarla gösterilmiştir. Gastrointestinal infeksiyonlara ve mide kanserlerine yol açan H. pylori’nin özellikle tekrarlayan ve ısrarcı infeksiyonlarda sekonder odağının ağız mukozası olabileceği düşünülmektedir. Oral H. pylori varlığı ile bireyin ağız hijyeni ve periodontal durumunun ilişkili olduğu gösterilmiştir. Kötü ağız hijyenine sahip olan bireylerde hastalığın rekürrens oranının daha yüksek olduğu ve ağız hijyeninin iyileştirilmesi sayesinde midedeki H. pylori enfeksiyonunun baskılanma oranının artabileceği rapor edilmiştir. Günümüzde H. pylori enfeksiyonu tedavisi, gastrik enfeksiyonu kontrol altına almada başarılı gözükmektedir. Ancak, tek başına yapılan sistemik H. pylori eradikasyon tedavisinin oral H. pylori varlığı üzerinde çok az etkisi olduğu bildirilmiştir. Gastrik H. pylori tedavisinin oral H. pylori varlığına etkilerinin yanı sıra periodontal tedavinin de gastrik H. pylori enfeksiyonu üzerine etkileri bulunmaktadır. Bu nedenlerden ötürü, H. pylori enfeksiyonunda, dental plak, tükürük ve periodontal hastalığın rolünün tanımlanması önem taşımaktadır. Bu derlemede H. pylori ve periodontal durum ilişkisi ulaşılabilir kaynaklar rehberliğinde sunulmuştur.

Keywords

• Helicobacter pylori
• dental plak
• periodontal hastalık

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