Summary: Poor oral health is strongly associated with higher rates of migraine, abdominal pain, and widespread musculoskeletal pain in women, particularly those with fibromyalgia. Researchers identified several oral microbes linked to increased pain scores, suggesting a possible connection among the oral microbiome, the gut-brain axis, and chronic pain.
Women reporting the poorest oral health were up to 60% more likely to report moderate to severe body pain and nearly 50% more likely to suffer migraines. These results emphasize that maintaining oral hygiene may influence more than dental outcomes — it could play a role in pain management and overall wellbeing.
Key facts:
- Pain correlation: Women with poorer oral health were 60% more likely to report moderate to severe body pain and 49% more likely to experience migraine headaches.
- Microbial associations: Specific oral bacteria, including species from the Dialister, Fusobacterium, Parvimonas and Solobacterium genera, were linked to chronic pain measures.
- Fibromyalgia focus: Two-thirds (67%) of study participants reported fibromyalgia, a commonly underdiagnosed condition characterized by widespread pain and related symptoms.
Source: University of Sydney
Overview
New research led by the University of Sydney examined the relationship between self-reported oral health, the composition of the oral microbiome, and several pain presentations in a cohort of New Zealand women, many of whom have fibromyalgia. Published in Frontiers in Pain Research, this study is among the first to link oral health measures and oral microbial profiles with migraine, abdominal pain and widespread body pain in women with central sensitisation disorders.
The investigators report that lower oral health scores were significantly associated with higher pain scores across several measures. After accounting for age, body mass index and added dietary sugars, four oral species remained significantly associated with bodily pain. The findings raise the possibility of an oral microbiome–nervous system axis contributing to pain in conditions such as migraine and fibromyalgia.
Research methods
Researchers recruited women with and without fibromyalgia and collected self-reported oral health data using the World Health Organization (WHO) oral health questionnaire. Pain outcomes were measured with validated instruments: health-related quality of life and bodily pain via the Short Form 36 (SF-36), headache and migraine features via the International Headache Society survey, and abdominal symptoms using the functional bowel disorder severity index. Saliva samples were analysed using metatranscriptomic techniques to estimate relative gene abundance and to profile the oral microbiota.
Demographic and clinical characteristics were examined for relationships among oral health scores, pain measures, and the oral microbial community at multiple taxonomic levels.
Key results
Participants in the lowest oral health quintile were significantly more likely to report migraine headaches and higher body pain scores. Specifically, poorer oral health predicted a 60% greater likelihood of moderate to severe bodily pain and a 49% greater likelihood of migraine. Lower oral health scores were also a statistically significant predictor of frequent and chronic migraine.
Four oral microbial species originating from the Dialister, Fusobacterium, Parvimonas and Solobacterium genera were significantly associated with bodily pain after controlling for confounders. Other taxa, including Gardnerella at the genus level, showed a moderate inverse correlation with oral health scores, while Lancefieldella and Mycoplasma salivarius were linked to migraine in this cohort.
The study also found a weak but statistically significant inverse relationship between overall diet quality and oral health, though the authors note this observation requires further detailed investigation.
Implications
These findings suggest that improving oral health could be a relevant component of strategies to reduce pain and enhance quality of life in women with chronic pain syndromes. The identified associations between specific oral pathobionts and pain measures support further exploration of oral microbiota as a factor in the development or maintenance of migraine, abdominal pain and widespread musculoskeletal pain.
Lead investigator Associate Professor Joanna Harnett (Faculty of Medicine and Health) said this is the first study to investigate links among oral health, the oral microbiome and pain in women with fibromyalgia. First author Sharon Erdrich, a PhD candidate in the Faculty of Medicine and Health, noted the importance of recognising fibromyalgia as a common but often overlooked rheumatological condition characterised by widespread pain, headaches, fatigue, disrupted sleep and cognitive symptoms.
Recommendations and declarations
The Australian Dental Association recommends regular dental check-ups, professional oral hygiene appointments, and routine home care including twice-daily tooth brushing and daily flossing.
Declaration: The study protocol and procedures received ethical approval from the New Zealand Health and Disability Ethics Committee. Written informed consent was obtained from all participants.
Funding and registration: The study was registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR) under registration number ACTRN12620001337965 and with the World Health Organization (UTN: U1111–1258-5108). The research was conducted with open-access publication of its findings.
About this research
Author: Luisa Low
Source: University of Sydney
Contact: Luisa Low – University of Sydney
Image credit: Neuroscience News
Original research: “An association between poor oral health, oral microbiota and pain identified in New Zealand women with central sensitisation disorders” by Joanna Harnett et al., published as open access in Frontiers in Pain Research.
Abstract
Title: An association between poor oral health, oral microbiota and pain identified in New Zealand women with central sensitisation disorders
Introduction: The oral cavity is the gateway to the gastrointestinal tract and hosts a mix of transient and resident microbes. Oral pathogens have been implicated in the development of several chronic conditions, yet the role of oral health and the oral microbiota in pain associated with central sensitisation disorders has been underexplored. This study investigates associations between self-reported oral health, the oral microbiome, and multiple pain presentations in women.
Methods: Oral health was measured with the WHO oral health questionnaire. Body pain, migraine and abdominal pain were assessed using validated instruments. Saliva samples underwent metatranscriptomic analysis to assess relative gene abundance and microbial composition. Relationships among oral health scores, pain measures and the oral microbiota were evaluated while accounting for demographic and clinical variables.
Results: Women in the lowest oral health quintiles were more likely to report migraine and elevated bodily pain scores. Four oral pathogenic species were significantly associated with SF-36 bodily pain after adjusting for confounders. Several taxa correlated with oral health and specific pain types.
Discussion: Lower oral health scores correlated with higher pain scores and a higher relative abundance of oral pathobionts. These results support a potential role for the oral microbiota in the development or perpetuation of pain experienced by women with migraine, abdominal pain and widespread body pain, and they justify further research into an oral microbiome–nervous system axis.