Dental Caries as a Source of Helicobacter Pylori Infection in Children
International Journal
of Paediatric Dentistry: Published April 2022
Dental
caries is the most common global oral health concern and is remarkably
prevalent in children. Early childhood caries (ECC) is a prevailing chronic
condition affecting the primary dentition, resulting in partial or gross
destruction of the teeth.
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In this cross-sectional study designed to assess the presence
of Helicobacter pylori in deep cavitated carious lesions and
evaluate its association with dental status and caries severity, the prevalence
rate of H pylori was 70% among the cavitated teeth of children
with a mean age of 4.8 years.
The presence of Helicobacter pylori in asymptomatic deep
carious lesions contributes to an aciduric environment and progression of early
childhood caries.
Prompt treatment of such deep cavities by pediatric dentists
can prevent the progression of early childhood caries.
A clear understanding of the presence of H. pylori and its
interaction with caries and other caries- causing microbes can contribute to
the management and treatment of early childhood caries.
The increased prevalence of H pylori in deep carious lesions suggests that the aciduric potential of H pylori may promote a favorable environment for Streptococcus mutans, enhancing caries activity and severity.
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Background: Findings on the presence of Helicobacter pylori in the oral
cavity are conflicting. This bacterium can occur either transiently in the oral
cavity or, in some situations, pose a threat to oral/gastric tissues.
Aim: Authors investigated the presence of H. pylori in deep carious
lesions of children and assessed its association with dental status and caries
severity.
Design: This cross-sectional study involved 20 children aged 3-6
years attending the paediatric outpatient clinic. Demographic and oral
hygiene-related data were obtained from parents/caregivers. Caries status and
severity were assessed using the DMFT and ICDAS II indices respectively.
Dentine samples were collected and stored in phosphate-buffered saline
solution. These samples were assessed for H. pylori using reverse transcription
polymerase chain reaction. DMFT and ICDAS II scores were compared between
children with and without H. pylori.
Results and conclusion: H. pylori was detected in 70% of children with severe carious lesions. The mean DMFT score was significantly higher in the group with H. pylori than in the group without. The prevalence of H. pylori was greater in those with ICDAS II code 6 than in those with ICDAS II code 5 carries. Cavitated carious lesions can serve as a reservoir for H. pylori. Its presence was associated with higher caries status and caries severity (ICDAS II code 6). The presence of H. pylori in such cavities may tip the balance of plaque ecosystem in favour of Streptococcus mutans, the main bacterial source in dental caries.
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