{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T06:27:20Z","timestamp":1766557640574,"version":"3.41.2"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The portal to the gastrointestinal tract is the oral cavity, with transient and permanent microbial residents. Oral pathogens are implicated in the aetiology of several chronic conditions. To date, the role of oral health and the oral microbiota in the aetiology of pain in sensitisation disorders have not been explored. Here, we examined associations between self-reported oral health, the oral microbiome, and various pain presentations in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Oral health in women was assessed using the WHO oral health questionnaire. Body pain, migraine, and abdominal pain were determined using validated instruments. Saliva samples were evaluated using metatranscriptomics for relative gene abundance. Demographic and clinical characteristics data were evaluated for relationships between oral health scores, pain measures, and the oral microbiota at three taxa levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants in the lowest quintiles for oral health were more likely to suffer migraine headaches (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200923.24, df 4, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and higher body pain scores. Four oral pathogenic species were significantly associated with SF36 bodily pain (<jats:italic>q<\/jats:italic>\u2009&amp;lt;\u20090.05) after controlling for confounders. Relative abundance of <jats:italic>Gardnerella<\/jats:italic> (genus) correlated moderately with oral health scores (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.346, <jats:italic>q<\/jats:italic>\u2009=\u20090.001), while <jats:italic>Lancefieldella<\/jats:italic> (genus) and <jats:italic>Mycoplasma salivarius<\/jats:italic> were associated with migraine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Low oral health scores correlated with higher pain scores. Both were associated with higher relative abundance of oral pathobionts. This suggests a potential role for the oral microbiota in the aetiology of pain experienced by women with migraine headache and abdominal and body pain. These findings prompt consideration of an oral microbiome\u2013nervous system axis.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>The study was registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12620001337965, on 11\/12\/2020 <jats:ext-link>https:\/\/www.anzctr.org.au\/<\/jats:ext-link>, and with the World Health Organisation, UTN: U1111\u20131258-5108.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1577193","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T05:23:23Z","timestamp":1744176203000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["An association between poor oral health, oral microbiota, and pain identified in New Zealand women with central sensitisation disorders: a prospective clinical study"],"prefix":"10.3389","volume":"6","author":[{"given":"Sharon","family":"Erdrich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid C.","family":"Gelissen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momchilo","family":"Vuyisich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Toma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna E.","family":"Harnett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1016\/s0140-6736(21)00393-7","article-title":"Chronic pain: an update on burden, best practices, and new advances","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e596","DOI":"10.1097\/j.pain.0000000000002431","article-title":"Neurobiological antecedents of multisite pain in children","volume":"163","author":"Kaplan","year":"2022","journal-title":"Pain"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/1756284820977402","article-title":"A systematic review of the association between fibromyalgia and functional gastrointestinal disorders","volume":"13","author":"Erdrich","year":"2020","journal-title":"Therap Adv Gastroenterol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12891-020-03201-9","article-title":"Determining the association between fibromyalgia, the gut microbiome and its biomarkers: a systematic review","volume":"21","author":"Erdrich","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13030-023-00275-4","article-title":"Systematic review and meta-analysis of calculating degree of comorbidity of irritable bowel syndrome with migraine","volume":"17","author":"Todor","year":"2023","journal-title":"BioPsychoSoc Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10194-016-0619-8","article-title":"Impact of migraine on fibromyalgia symptoms","volume":"17","author":"Giamberardino","year":"2016","journal-title":"J Headache Pain"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3085","DOI":"10.2147\/jpr.s411451","article-title":"Polypharmacy and excessive polypharmacy among persons living with chronic pain: a cross-sectional study on the prevalence and associated factors","volume":"16","author":"Zahlan","year":"2023","journal-title":"J Pain Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5002","DOI":"10.1128\/jb.00542-10","article-title":"The human oral microbiome","volume":"192","author":"Dewhirst","year":"2010","journal-title":"J Bacteriol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1038\/nature13178","article-title":"Dynamics and associations of microbial community types across the human body","volume":"509","author":"Ding","year":"2014","journal-title":"Nature"},{"key":"B12","doi-asserted-by":"publisher","first-page":"625579","DOI":"10.3389\/fcvm.2020.625579","article-title":"Association between periodontal disease and atherosclerotic cardiovascular diseases: revisited","volume":"7","author":"Zardawi","year":"2020","journal-title":"Front Cardiovasc Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"4757","DOI":"10.1007\/s00784-023-05104-0","article-title":"Microbiota present in combined endodontic-periodontal diseases and its risks for endocarditis","volume":"27","author":"Gomes","year":"2023","journal-title":"Clin Oral Investig"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e00105","DOI":"10.1128\/msystems.00105-16","article-title":"Migraines are correlated with higher levels of nitrate-, nitrite-, and nitric oxide-reducing oral microbes in the American gut project cohort","volume":"1","author":"Gonzalez","year":"2016","journal-title":"mSystems"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12891-023-06259-3","article-title":"Investigating the association between the symptoms of women with fibromyalgia, digestive function, and markers of the microbiota of the gastrointestinal tract (the FIDGIT study): study protocol","volume":"24","author":"Erdrich","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"B16","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 revisions to the 2010\/2011 fibromyalgia diagnostic criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"B17","doi-asserted-by":"publisher","first-page":"102497","DOI":"10.1016\/j.msksp.2021.102497","article-title":"Development of an automated tool to score the headache screening questionnaire: agreement between automated and manual scoring","volume":"57","author":"Aleida van der Meer","year":"2022","journal-title":"Musculoskelet Sci Pract"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1038\/ajg.2011.201","article-title":"Severity in irritable bowel syndrome: a Rome foundation working team report","volume":"106","author":"Drossman","year":"2011","journal-title":"Am J Gastroenterol"},{"volume-title":"Oral Health Surveys: Basic Methods","year":"2013","author":"Petersen","key":"B19"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1177\/0022034512460676","article-title":"Construct validity of Locker\u2019s global oral health item","volume":"91","author":"Thomson","year":"2012","journal-title":"J Dent Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav Res Methods"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41467-022-28034-z","article-title":"Microbiome differential abundance methods produce different results across 38 datasets","volume":"13","author":"Nearing","year":"2022","journal-title":"Nat Commun"},{"key":"B23","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.chemolab.2015.02.019","article-title":"Zcompositions \u2014 R package for multivariate imputation of left-censored data under a compositional approach","volume":"143","author":"Palarea-Albaladejo","year":"2015","journal-title":"Chemometr Intell Lab Syst"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e67019","DOI":"10.1371\/journal.pone.0067019","article-title":"ANOVA-like differential expression (ALDEx) analysis for mixed population RNA-Seq","volume":"8","author":"Fernandes","year":"2013","journal-title":"PLoS One"},{"key":"B25","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1111\/idj.12480","article-title":"Obesity, dietary sugar and dental caries in Australian adults","volume":"69","author":"Barrington","year":"2019","journal-title":"Int Dent J"},{"volume-title":"Vegan: Community Ecology Package","year":"2024","author":"Oksanen","key":"B26"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e05371","DOI":"10.1016\/j.heliyon.2020.e05371","article-title":"Small, but smelly: the importance of Solobacterium moorei in halitosis and other human infections","volume":"6","author":"Barrak","year":"2020","journal-title":"Heliyon"},{"key":"B28","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1034\/j.1600-0765.2002.05019.x","article-title":"Dialister pneumosintes, a new putative periodontal pathogen","volume":"37","author":"Ghayoumi","year":"2002","journal-title":"J Periodontal Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.mib.2014.11.013","article-title":"Fusobacterium nucleatum: a commensal-turned pathogen","volume":"23","author":"Han","year":"2015","journal-title":"Curr Opin Microbiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-72132-1","article-title":"Parvimonas micra as a putative non-invasive faecal biomarker for colorectal cancer","volume":"10","author":"L\u00f6wenmark","year":"2020","journal-title":"Sci Rep"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e3000788","DOI":"10.1371\/journal.pbio.3000788","article-title":"Glycan cross-feeding supports mutualism between Fusobacterium and the vaginal microbiota","volume":"18","author":"Agarwal","year":"2020","journal-title":"PLoS Biol"},{"key":"B32","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/B978-1-4377-1604-7.00325-0","article-title":"Mycoplasma infections","volume-title":"Goldman\u2019s Cecil Medicine","author":"Baum","year":"2012"},{"key":"B33","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/j.1574-695x.1998.tb01212.x","article-title":"Detection of Mycoplasma salivarium and Mycoplasma fermentans in synovial fluids of temporomandibular joints of patients with disorders in the joints","volume":"22","author":"Watanabe","year":"1998","journal-title":"FEMS Immunol Med Microbiol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fmicb.2019.01099","article-title":"Acidogenic potential of oral Bifidobacterium and its high fluoride tolerance","volume":"10","author":"Manome","year":"2019","journal-title":"Front Microbiol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"13267","DOI":"10.3390\/ijms232113267","article-title":"The role of the human microbiome in the pathogenesis of pain","volume":"23","author":"Ustianowska","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B36","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s40122-023-00565-3","article-title":"Gut microbiota modulation and its implications on neuropathic pain: a comprehensive literature review","volume":"13","author":"Corriero","year":"2024","journal-title":"Pain Ther"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19490976.2022.2068365","article-title":"Communication between the gut microbiota and peripheral nervous system in health and chronic disease","volume":"14","author":"Cook","year":"2022","journal-title":"Gut Microbes"},{"key":"B38","doi-asserted-by":"publisher","first-page":"8061","DOI":"10.3390\/ijms24098061","article-title":"Impact of gut microbiota on the peripheral nervous system in physiological, regenerative and pathological conditions","volume":"24","author":"Calabr\u00f2","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B39","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1097\/j.pain.0000000000000831","article-title":"The role of calcitonin gene\u2013related peptide in peripheral and central pain mechanisms including migraine","volume":"158","author":"Iyengar","year":"2017","journal-title":"Pain"},{"key":"B40","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1177\/154405910708600212","article-title":"Bacterial infection promotes DNA hypermethylation","volume":"86","author":"Bobetsis","year":"2007","journal-title":"J Dent Res"},{"key":"B41","doi-asserted-by":"publisher","first-page":"10443","DOI":"10.3390\/ijms241310443","article-title":"Pain biomarkers in fibromyalgia syndrome: current understanding and future directions","volume":"24","author":"Favretti","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1152\/physrev.00034.2013","article-title":"Calcitonin gene-related peptide: physiology and pathophysiology","volume":"94","author":"Russell","year":"2014","journal-title":"Physiol Rev"},{"key":"B43","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/j.1365-2567.2009.03239.x","article-title":"Lipopolysaccharide induces calcitonin gene-related peptide in the RAW264.7 macrophage cell line","volume":"130","author":"Ma","year":"2010","journal-title":"Immunology"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10194-017-0741-2","article-title":"Calcitonin gene-related peptide and pain: a systematic review","volume":"18","author":"Schou","year":"2017","journal-title":"J Headache Pain"},{"key":"B45","doi-asserted-by":"publisher","first-page":"104981","DOI":"10.1016\/j.neuint.2021.104981","article-title":"Attenuation of nociceptive and paclitaxel-induced neuropathic pain by targeting inflammatory, CGRP and substance P signaling using 3-hydroxyflavone","volume":"144","author":"Ullah","year":"2021","journal-title":"Neurochem Int"},{"key":"B46","doi-asserted-by":"publisher","first-page":"e0262769","DOI":"10.1371\/journal.pone.0262769","article-title":"Pharmacogenetic inhibition of lumbosacral sensory neurons alleviates visceral hypersensitivity in a mouse model of chronic pelvic pain","volume":"17","author":"Xie","year":"2022","journal-title":"PLoS One"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10194-021-01377-6","article-title":"Assessment of peripheral biomarkers potentially involved in episodic and chronic migraine: a case-control study with a focus on NGF, BDNF, VEGF, and PGE2","volume":"23","author":"Mozafarihashjin","year":"2022","journal-title":"J Headache Pain"},{"key":"B48","doi-asserted-by":"publisher","first-page":"15533","DOI":"10.3390\/ijms242115533","article-title":"Serum VEGF and CGRP biomarkers: relationships with pain intensity, electric pain, pressure pain threshold, and clinical symptoms in fibromyalgia\u2014an observational study","volume":"24","author":"Tapia-Haro","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B49","doi-asserted-by":"publisher","first-page":"158","DOI":"10.4103\/njecp.njecp_21_21","article-title":"Vascular endothelial growth factor levels in the gingival crevicular fluid of type II diabetes mellitus patients with and without chronic periodontitis \u2013 a clinico-biochemical study","volume":"9","author":"Rujuta","year":"2021","journal-title":"Nigerian J Exp Clin Biosci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"189","DOI":"10.3109\/08830185.2015.1087518","article-title":"The characteristics and function of bacterial lipopolysaccharides and their endotoxic potential in humans","volume":"35","author":"Gnauck","year":"2016","journal-title":"Int Rev Immunol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1038\/s41569-022-00737-2","article-title":"Gut-derived low-grade endotoxaemia, atherothrombosis and cardiovascular disease","volume":"20","author":"Violi","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"eabq8476","DOI":"10.1126\/scitranslmed.abq8476","article-title":"Oral mucosal breaks trigger anti-citrullinated bacterial and human protein antibody responses in rheumatoid arthritis","volume":"15","author":"Brewer","year":"2023","journal-title":"Sci Transl Med"},{"key":"B53","doi-asserted-by":"publisher","first-page":"2523","DOI":"10.1080\/21655979.2021.1933840","article-title":"A 16S rRNA gene sequencing based study of oral microbiota in migraine patients in China","volume":"12","author":"Jiang","year":"2021","journal-title":"Bioengineered"},{"key":"B54","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/ni.2608","article-title":"Control of pathogens and pathobionts by the gut microbiota","volume":"14","author":"Kamada","year":"2013","journal-title":"Nat Immunol"}],"container-title":["Frontiers in Pain Research"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2025.1577193\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T05:23:28Z","timestamp":1744176208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2025.1577193\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":54,"alternative-id":["10.3389\/fpain.2025.1577193"],"URL":"https:\/\/doi.org\/10.3389\/fpain.2025.1577193","relation":{},"ISSN":["2673-561X"],"issn-type":[{"type":"electronic","value":"2673-561X"}],"subject":[],"published":{"date-parts":[[2025,4,9]]},"article-number":"1577193"}}