Gastric Helicobacter pylori infection does not contribute to extraoral halitosis and its eradication cannot achieve substantial reduction of halitosis

Abstract

AbstractBackgroundSome researchers have suggested that Helicobacter pylori (H. pylori) infection is attributed to extraoral halitosis. However, this viewpoint is increasingly challenged by clinical practice. This study was conducted with the aim of investigating changes of extraoral halitosis before and after H. pylori eradication.Materials and MethodsData of patients who had H. pylori infection and extraoral halitosis were retrospectively collected. H. pylori infection was diagnosed by positive 13C urea breath test (UBT). Extraoral halitosis was diagnosed by organoleptic score (OLS) ≥2 in nose breath. A 14‐day bismuth‐based quadruple therapy was administered for H. pylori eradication. Extraoral halitosis was examined before eradication (T1), on the first day after eradication (T2), 1 month after eradication (T3), and 3 months after eradication (T4). Eradication effect was checked by UBT at T3.ResultsA total of 100 patients were included. Eradication was successful in 74 out of 100 (74%) patients (success group) and failed in 26 out of 100 (26%) patients (failure group). 32 out of 74 (43.24%) patients in success group and 10 out of 26 (38.46%) patients in failure group had reduced halitosis at T2, 9 out of 74 (12.16%) patients in success group and 2 out 26 (7.69%) patients in failure group had relapsed halitosis at T3, and 23 out of 74 (31.08%) patients in success group and 8 out of 26 (30.77%) patients in failure group had relapsed halitosis at T4, without significant difference between groups at any time (p = 0.918, p = 0.808, and p = 0.808 respectively).ConclusionsHelicobacter pylori infection does not contribute to extraoral halitosis. H. pylori eradication can achieve sustained but slight reduction of extraoral halitosis, probably due to its antibiotic effects on the gut microbiota rather than H. pylori.