Paper Title
Is Oral Bacterial Flora with Dental Disease a Risk Factor for Recurrence of Pepticulcer Disease? A Retrospective Study on 644 Patients

Abstract
Background: From last few years, peptic ulcer disease (PUD) had significant role in morbidity and mortality. In presence of dental diseases oral bacterial flora usually contains relevant bacteria. Aim:The aim of study was to verify effect of oral bacterial flora with dental disease, on recurrence of peptic ulcer disease. Materials and methods:A retrospective cohort study was conducted on 644patients who were admitted and diagnosed with peptic ulcer disease in a rural medical institute in Udaipur city, Rajasthan, India. Complete medical files and reports were examined through our trained studyinvestigators and relevant findings were recorded. Patient�sexposure to oral bacterial flora with dental disease assistedthrough gastroscopic testfindings before and after the exposure period, and the patients were divided into 2 groups as �exposed group (patient with one of the dental diseases in oral cavity)and non-exposed group (patient without one of the dental diseases in oral cavity)�.Furthermore, follow up of six month of recurrence of PUD wasscheduled. The recurrence of PUD was considered as the outcome of the study and effect of oral bacterial flora with dental disease on recurrence of PUD was investigated according to a logistic regression model. RESULT: Out of total,644 patients were fulfilled the inclusion criteria and all patients have history of PUD. The six month follow up results were the oral bacteria flora with dental disease a 1.54 times the odds of peptic ulcer disease recurrence at patient level (P= 0.128; 95% CI for OR ranged from 0.88 to 2.68 ) for exposed and non-exposed group with existing systemic factors and 1.95 times the odd of peptic ulcer disease at patient level(P= 0.010; 95% CI for OR ranged from 1.17 to 3.23 ) for exposed and non-exposed group without existing systemic factors in which statistically significance difference were seen. Conclusion: The oral bacteria flora with dental disease tends to increase the risk of recurrence of Peptic ulcer disease. Conflict-of-interest statements: All authors hereby declare that they have no conflict of interest. Fundings: NIL Keywords - �Cohort study� or �Dental disease�or �Oral bacterial flora� or�Peptic ulcer disease�. Abbreviations: PUD-peptic ulcer disease, H.pylori� - helicobacter pylori, NSAID- non steroidal anti-inflammatory drugs.