The presence of dental disease can be a risk factor for recurrent Helicobacter pylori infection after eradication therapy: A 3-year follow-up

Background and study aim: We investigated whether dental disease might be associated with a higher recurrence of Helicobacter pylori infection after successful eradication by triple therapy. Patients and methods: Consecutive patients with successful H. pylori eradication, defined by negative results for both histology and ¹³C-urea breath test (UBT) performed 6 weeks after triple therapy, were enrolled in the study. Each patient was scheduled for serial UBT and dental assessments at the end of the first, second, and third years. Patients were categorized into a "dental disease" group or "no dental disease" group at the first-year follow-up. Patients in the dental disease group whose dental disease had been cured during the second- and third-year follow-up periods, were transferred to a "dental treatment" group. Results: The first-year H. pylori recurrence rate was higher in the 159 patients with dental disease than in those 200 patients without dental disease (13.2% vs. 3.5%, p <0.001; relative risk [95 %CI], 4.2 [1.7 - 10.1]). At both the second-year and the third-year follow-up, the annual H. pylori recurrence rates were higher in the dental disease group than in the no dental disease group or dental treatment group (second year, 18.4% vs.2.8% or vs. 5.7%, p <0.001; third year, 20% vs. 3.8% or vs. 6.3%, p < 0.001). Conclusion: The presence of dental disease could predispose to recurrent H. pylori infection after successful eradication. Dental surveillance and care after H. pylori eradication is a rational step for preventing recurrence of H. pylori, especially in those with dental diseases.