Halitosis and Helicobacter pylori - A possible relationship

With the aim of investigating a possible relationship between "objective" h alitosis (established by sulfide levels in the breath) and Helicobacter pyl ori, we performed a study in 58 dyspeptic patients reported to suffer from "bad breath." Furthermore, we evaluated the effects on halitosis of eradica tion therapy (only for H. pylori-positive patients) and chlorhexidine antis eptic mouth rinses (in all patients). Sulfide compound assay indicated obje ctive halitosis in 52/58 patients, 30 of whom were positive and 22 negative for H, pylori. In 19/30 eradication by double therapy provoked a decrease to below the cutoff value of sulfide levels in 15. In the other 11 of the 3 0 subjects, in whom H. pylori positivity persisted, halitosis parameters di d not change. Chlorexidine reduced sulfides to below the cutoff value in 16 /22 H. pylori-negative patients, but did not provoke any change in the 11 u nsuccessfully treated H. pylori-positive subjects. In these, objective hali tosis disappeared only after a successful eradication by triple therapy (9/ 11). Our results show a possible association between halitosis and H. pylor i since bacterial eradication may resolve the symptom. Antiseptic mouthwash es may be effective only in absence of H. pylori when halitosis may be due to oral putrefactive microbial activity. In a small number of subjects the cause and treatment of halitosis need to be clarified.