Helicobacter pylori and Bad Breath

Researchers in Japan have found a link between Helicobacter pylori and bad breath (halitosis). Helicobacter pylori is known to cause stomach ulcers, and doctors have long suspected that some cases of bad breath (halitosis) are linked to stomach problems but, until now, scientific proof has been lacking. The study, reported in the Journal of Medical Microbiology (J Med Microbiol 57 (2008), 1553-1559), looked for the presence of H. pylori in the mouths of 326 subjects, 251 of whom suffered from oral malodor. The results indicted an association with not only halitosis, but also gum disease.

Does this mean stomach ulcer and halitosis go hand in hand? Not necessarily. Not all people who carry H. pylori have stomach ulcers, just as not all of them have oral malodor. The authors of the recent report suggest that gum disease may predispose people to having H. pylori in the mouth—that is, gum disease may create the ideal conditions for the bacterium to multiply in the mouth if it is introduced. Poor oral health, then, may be a stepping stone to Helicobacter pylori and bad breath.

Obviously, contact with this organism can increase the risk of both stomach ulcer and bad breath, since any organism that is found in the mouth is presumably also found in the stomach. Once assumed to be a harmless environmental bacterium, it is emerging as a significant cause of human health problems. It remains to be seen however, whether the evidence linking Helicobacter pylori and bad breath sparks additional research and increased efforts to find good antibiotic treatment.

For oral malodor sufferers, knowledge of a possible cause and effect relationship between Helicobacter pylori and bad breath may spark a desire to be tested for the organism. There is a blood test available for screening, though it’s probably not known whether it will detect the organism in oral tissues. Ironically, a urea breath test has also been developed, the results of which may be questionable now that we know the bacterium can live in the mouth: this test may not differentiate between stomach ulcer and bad breath. The reported study used detection of specific DNA, an approach not likely to be available to the general public.