Oral Health and Body Pain, Migraines Significantly Correlated in Women

A new study has found that low oral health (OH) was correlated with more migraines and higher body pain scores in women.1

“This is the first study to investigate OH, oral microbiota and pain commonly experienced in women with fibromyalgia, with our study showing a clear and significant association between poor OH and pain," lead investigator Joanna Harnett, BHSc, MHSc, PhD, Associate Professor, University of Sydney, and Charles Perkins Centre's oral and systemic health research node, said in a statement.2

Harnett and colleagues collected data on OH using the WHO OH questionnaire. They also determined body pain, migraine, and abdominal pain using validated instruments including short-form 36 (SF36) domain ‘bodily pain’ (SF36-BP), widespread pain index (WPI), headache symptom questionnaire (HSQ), and functional bowel disorder severity index (FBDSI). They evaluated saliva samples using metatranscriptomics for relative gene abundance. Lastly, they analyzed demographic and clinical characteristics for relationships between OH scores, pain measures, and the oral microbiota at 3 taxa levels.

The analysis included 168 women from Auckland, New Zealand, from December 2021 to December 2022, data from 158 that oral microbiome data were available for were included from the analysis. The healthy eating index was weakly correlated with OH (ρ = .205 [P = .01; 95% CI, 0.05–0.35]), and inversely with BMI (P = .03; 95% CI, −0.32 to −0.02).

The investigators found that participants in the lowest quintiles for OH were more likely to suffer migraine headaches (χ2 = 23.24, df 4, P <.001) and higher body pain scores. Specifically, inverted SF36-BP had a ρ of -0.552 (95% CI, -.66 to -.43; P <.001), WPI had a ρ of -0.555 (95% CI, -.66 to -.43; P <.001), and migraine symptom score had a ρ of -.388 (95% CI, -.52 to -.241; P <.001), and FBDSI had a ρ of -.475 (95% CI, -.59 to -.34; P <.001).

Participants with migraine had significantly lower OH scores compared to those without migraine (mean,188.0; standard deviation [SD], 16.8 vs 199.0; SD, 14.7; P <.001; 95% CI, −15.7 to −1.6). Lower OH scores were associated with greater migraine burden, with higher prevalence of both frequent and chronic migraine in lower OH groups (χ² = 34.8, df = 12; P <.001). A Kruskal–Wallis H test confirmed a significant overall association between migraine type and OH score (H = 24.5, df = 3; P <.001), particularly between non-migraine and both frequent and chronic migraine groups (all P ≤.001 after Bonferroni correction).

Logistic regression showed OH score was a significant inverse predictor of migraine frequency. Each unit increase in OH score was associated with lower odds of frequent (OR = 0.95; P <.001) and chronic migraine (OR = 0.92; P <.001). Higher BMI also significantly increased odds of frequent (OR = 1.10; P = .003) and chronic migraine (OR = 1.13; P = .004), while age was not a significant factor.

FBDSI severity was similarly linked to OH scores. A Kruskal–Wallis H test revealed a significant difference in OH by bowel disorder severity (H = 42.5, df = 3; P <.001), with post hoc tests confirming lower OH scores among those with mild, moderate, and severe FBDSI compared to participants without functional bowel disorders (all comparisons P <.001 after Bonferroni correction).

Looking at oral microbiota, they found that 4 oral pathogenic species were significantly associated with SF36 bodily pain (q <.05) after controlling for confounders (Parvimonas micra, Solobacterium moorei, Dialister pneumosintes, and Prevotella denticola). Relative abundance of Gardnerella (genus) correlated moderately with OH scores (ρ = −0.346, q = 0.001), while Lancefieldella (genus) and Mycoplasma salivarius were associated with migraine.

“Our findings are particularly important to fibromyalgia which, despite being a common rheumatological condition, is often underrecognised,” investigator Sharon Erdrich, PhD candidate in the Faculty of Medicine and Health at University of Sydney added.2 “Fibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, and headaches including headaches, as well as fatigue, sleep disturbances, and cognitive problems."

REFERENCES

1. Erdrich S, Gelissen IC, Vuyisich M, Toma R, Harnett JE. 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. doi: 10.3389/fpain.2025.1577193

2. Poor oral health linked with body pain and migraines in women. The University of Sydney. Published 2025. Accessed July 15, 2025. https://www.sydney.edu.au/news-opinion/news/2025/04/10/poor-oral-health-linked-with-body-pain-and-migraines-in-women--.html