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This hybrid study, combining a scoping review and a pilot clinical study, aimed to synthesise global evidence on oral\n                      <jats:italic>H. pylori<\/jats:italic>\n                      detection and investigate the discrepancy between molecular and culture-based findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A scoping review following JBI and PRISMA-ScR guidelines identified human studies reporting oral\n                      <jats:italic>H. pylori<\/jats:italic>\n                      detection using molecular and\/or culture-based methods. Review findings guided a pilot clinical study in which supragingival plaque and oral mucosal swabs were collected from symptomatic and asymptomatic\n                      <jats:italic>H. pylori<\/jats:italic>\n                      -positive individuals. Detection was performed using nested PCR (16\u00a0S rRNA and\n                      <jats:italic>ureA<\/jats:italic>\n                      ) and selective microaerophilic culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-nine studies involving over 3,000 participants were included. Molecular detection rates varied widely (0\u201390%), while culture-confirmed viable\n                      <jats:italic>H. pylori<\/jats:italic>\n                      was exceedingly rare and restricted to protected anaerobic oral niches. In the pilot study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), PCR detected\n                      <jats:italic>H. pylori<\/jats:italic>\n                      DNA in 50% of participants, with higher detection in mucosal swabs (37.5%) than supragingival plaque (25%). No viable organisms were recovered by culture, which was dominated by commensal oral species.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Both the scoping review and pilot study consistently demonstrated a PCR-positive\/culture-negative pattern for oral\n                      <jats:italic>H. pylori<\/jats:italic>\n                      . These findings suggest that oral detection likely reflects transient bacterial presence rather than stable colonisation. Future studies should employ multi-gene molecular assays, targeted sampling, viability-based techniques, and gastric\u2013oral strain comparisons to clarify the biological significance of oral\n                      <jats:italic>H. pylori<\/jats:italic>\n                      detection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>\n                      Although\n                      <jats:italic>H. pylori<\/jats:italic>\n                      DNA is frequently detected in oral samples, viable organisms are rarely identified. Oral PCR positivity should therefore not be interpreted as active infection, and clinical management should continue to rely on established gastric diagnostic pathways.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-07134-w","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:31:00Z","timestamp":1789630260000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Helicobacter pylori: a scoping review and pilot study on the PCR-culture detection paradox"],"prefix":"10.1007","volume":"30","author":[{"given":"Erin","family":"Miller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin Pyu Pyu Wai","family":"Htun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie-Anne","family":"Martis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kausar Sadia","family":"Fakhruddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng","family":"Chua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooi","family":"Ee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin A.","family":"Paz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3481-1621","authenticated-orcid":false,"given":"Victor Haruo","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"7134_CR1","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1111\/j.1399-302X.2006.00295.x","volume":"21","author":"J Martinez-Gomis","year":"2006","unstructured":"Martinez-Gomis J, Diouf A, Lakhssassi N, Sixou M (2006) Absence of Helicobacter pylori in the oral cavity of 10 non-dyspeptic subjects demonstrated by real-time polymerase chain reaction. 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