The Oral Cavity as a Multi-Reservoir Ecosystem of Helicobacter pylori
DOI:
https://doi.org/10.70577/qgypnq90Keywords:
Helicobacter pylori; oral cavity; saliva; dental plaque; dental biofilm; oral reservoir.Abstract
Helicobacter pylori is primarily recognized for its colonization of the gastric mucosa; however, its detection at different sites within the oral cavity has generated increasing interest in the potential role of this environment as an extragastric reservoir. Objective: To systematically analyze the distribution of H. pylori across different niches of the oral cavity through prevalence in saliva, dental plaque or biofilm, dental pulp, and tongue, while examining the influence of study characteristics on the observed variability. Methods: A systematic review with quantitative synthesis of original studies published between January 2015 and August 2026 was conducted. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and ScienceDirect and were supplemented by manual screening of reference lists. Human studies assessing H. pylori in at least one oral niche using identifiable diagnostic techniques and providing quantitative detection data were included. Studies were organized according to sampling site and diagnostic technique, following the PRISMA 2020 recommendations. Results: Sixteen studies, mainly from Asia and Latin America, were included. H. pylori was identified in saliva, dental plaque or biofilm, tongue, dental pulp, and other oral structures. In saliva, reported prevalence ranged from 0.0% to 85.4%, whereas in dental plaque or biofilm it ranged from 1.0% to 66.7% among studies with clearly identifiable numerators and denominators; additionally, one study reported values above 80% for supra- and subgingival plaque. Tongue prevalence was 2.3% and 10.8%, while dental pulp prevalence ranged from 2.6% to 38.9%. Studies that simultaneously assessed multiple oral sites did not identify a consistently predominant niche. Variability was also observed according to the molecular technique used, even when the same samples were analyzed. Conclusions: Available evidence demonstrates that H. pylori can be detected across multiple niches of the oral cavity, supporting its characterization as a potential multi-reservoir ecosystem. Dental plaque or biofilm is one of the most consistently investigated compartments, whereas saliva shows substantial variability, and evidence regarding the tongue and dental pulp remains limited. Population and methodological heterogeneity, together with the predominance of molecular techniques, prevents bacterial DNA detection from being equated with viable colonization or from establishing a causal relationship with gastric persistence or reinfection.
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Copyright (c) 2026 Islam Villegas Elías Alfonso, Hidalgo Rodríguez Héctor Israel, Chamba Pilay Víctor Eduardo, Camacho Sig Tú Sandra Estefanía (Autor/a)
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