Frequently reported H. pylori antimicrobial therapy failures suggest that there might be a different niche where the bacteria can stay safe. Current study aims to examine potential role of oral colonization of H. pylori to feed reinfection after primary therapy. However, patients who were admitted to the gastroscopy section were chosen and gastric biopsy and dental plaque specimens were collected. Molecular and biochemical tests were applied to confirm H. pylori identity in different colonization niches. Results showed that 88.8% of dyspeptic patients had epigastric pains with nocturnal awakening when they were hungry ( ). All patients who received therapy already were again H. pylori positive while they are still carrying H. pylori in dental plaque ( ). Moreover, H. pylori infection was sought in 100% of gastric biopsy’s dyspeptic patients who had ulcerated esophagitis and erosive duodenitis and who were H. pylori positive, and 75% of dyspeptic patients with duodenum deformity had this bacterium in gastric biopsies ( ). Present study showed that only successful eradication of gastric H. pylori cannot guarantee prevention of reinfection. Conclusively, a new strategy which indicates concomitant eradication in oral and gastric colonization can result in clearance of H. pylori infection. 1. Introduction Helicobacter pylori (H. pylori) is a Gram-negative, spiral, and motile bacterium that is present in the human stomach of approximately half of the world’s population [1]. H. pylori is an important gastrointestinal pathogen that is strongly associated with gastritis as well as peptic ulcer disease. There is strong evidence that H. pylori has an undeniable role in occurrence of gastric abnormality, atrophic inflammation, and gastric cancer [2]. Colonization begins in childhood; however, little is known about its timing and actual route of bacterial transmission [3, 4]. Recent findings are indicating a narrow link between oral and gastric colonization of H. pylori [5]. Frequently failed antibiotic therapy to cure H. pylori infection suggests that there might be certain different sites where the organism can survive [1, 6]. To date, the exact mechanism of transmission of H. pylori is not fully understood, a crucial fact which implies on unknown routes and reservoir locations that are still undiscovered. Indeed, defeated therapeutic approaches to cure gastric H. pylori infection triggered a thought that different locality might be involved in reinfection of this persistent bacterium [6]. Nonetheless, alarm symptoms and endoscopic finding are such approach to
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