POOR oral health is strongly associated with increased migraine, abdominal, and musculoskeletal pain in women, with specific oral microbes linked to higher pain scores, according to a prospective clinical study of New Zealand women with central sensitisation disorders.
While the relationship between oral health and systemic diseases is well established, its role in pain syndromes, particularly in women with central sensitisation disorders such as fibromyalgia, has not been thoroughly explored. This study aimed to investigate the associations between self-reported oral health, the oral microbiome, and various pain presentations in women, including those with and without fibromyalgia.
Researchers assessed oral health using the World Health Organization oral health questionnaire and measured pain using validated tools for body pain, migraine, and abdominal pain. Saliva samples were analysed using metatranscriptomics to determine the relative abundance of oral microbes. Among the participants, 67% had fibromyalgia. The results showed that women in the lowest quintiles for oral health were 60% more likely to report moderate to severe body pain and 49% more likely to experience migraines compared to those with better oral health. Lower oral health scores were also a significant predictor of frequent and chronic migraine. Four oral microbial species,Dialister, Fusobacterium, Parvimonas, and Solobacterium, were significantly associated with higher pain scores, even after adjusting for age, BMI, and dietary sugar intake. The genus Gardnerella was moderately correlated with poorer oral health, while Lancefieldella and Mycoplasma salivarius were linked to migraine. A weak but significant inverse relationship was also found between diet quality and oral health.
These findings suggest that poor oral health and an altered oral microbiome may play a role in the development or exacerbation of pain in women with central sensitisation disorders. For clinical practice, this highlights the importance of regular oral hygiene and dental check-ups as part of a holistic approach to managing chronic pain, especially in women with fibromyalgia or similar conditions. Further research is needed to clarify the mechanisms linking oral microbes to pain and to explore whether improving oral health can reduce pain severity or frequency in this population.
Reference
Erdrich S et al. An association between poor oral health, oral microbiota and pain identified in New Zealand women with central sensitisation disorders. A prospective clinical study. Frontiers in Pain Research. 2025;6:1577193.
