Oral Health and Pain Syndromes in Women: Are They Connected?

Poor oral health corresponds to higher pain severity, according to study findings published in Frontiers in Pain Research.

While research has shown a link between oral microbes and migraine, there is limited information about oral health, oral microbiota and migraine, and other pain disorders among women.

In a prospective analysis, researchers studied the effect of poor oral health on pain presentations in women.

Eligible participants were women enrolled in the primary study (ANZCTR Number: ACTRN12620001337965) who did not smoke or have any chronic inflammatory condition or diabetes between December 2011 and 2022.

The researchers collected and evaluated data regarding body pain, migraine, abdominal pain, and oral health and microbiome using a set of self-reported questionnaires.

A total of 158 participants (mean age, 45.7 years; New Zealander, 71.8%; mean body mass index [BMI], 28.5) were included in the current study, of whom 156 provided oral health data.

Self-reported oral health scores were significantly associated with all measures of pain (P <.001).

A total of 10.8% of participants who completed the Short-Form 36 (SF36) for body pain rated their pain as a 0 of 100, with 31.0% and 23.4% reporting moderate and severe pain, respectively.

The researchers found that women with vs without migraine had lower total oral health scores (mean, 188 vs 199, respectively; P <.001), with those in the lowest oral health quintiles more likely to have migraine headaches (χ²=23.24; P <.001). The association between migraine type and oral health was also significant (H=24.5; P <.001). Overall, oral health was a significant predictor of frequent and chronic migraine, with higher scores associated with lesser odds of frequent or chronic migraine (odds ratios [ORs], 0.95 and 0.92, respectively).

Severity of abdominal pain, as measured by the Functional Bowel Disorder Severity Index (FBDSI), was associated with oral health scores.

After analyzing saliva samples, the relative abundance of 52 species was significantly associated with oral health scores. Inverse correlations were seen for 16 species, with the strongest correlation coefficient being for Gardnerella vaginalis (P =-.379).

The researchers noted that SF36 scores were correlated with 28 species, of which 25 remained significant (P ≤.10). Relative abundance of Gardnerella correlated with oral health scores (P =-346), while Lancefieldella and Mycoplasma salivarius were associated with migraine.

Overall, low oral health scores were found to be associated with higher pain scores, as well as a higher relative abundance of oral pathobionts.

Limitations of the analysis included that oral health scores were based on self-reported measures and limited generalizability of the findings to only those with migraine.

“Subject to larger studies confirming these findings, we propose that the oral microbiome has a role in pain signaling and requires consideration of an oral microbiome–nervous system axis,” the researchers concluded.

One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.