An association between poor oral health, oral microbiota and pain identified in New Zealand women with central sensitisation disorders. A prospective clinical study Authors

Sharon Erdrich ^1* Ingrid Gelissen ¹ Momchilo Vuyisich ² Ryan Toma ² Joanna E Harnett ^1*

• ¹ The University of Sydney, Darlington, Australia
• ² Viome Life Sciences, Bothell, United States

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.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.Participants in the lowest quintiles for oral health were more likely to suffer migraine headache (X 2 =23.24, df 4, p < 0.001) and higher body pain scores. Four oral pathogenic species were significantly associated with SF36-Bodily Pain (q <0.05) after controlling for confounders. Relative abundance of Gardnerella (genus) correlated moderately with oral health scores (ρ = -0.346, q = 0.001), while Lancefieldella (genus) and Mycoplasma salivarius were associated with migraine.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, abdominal, and body pain. These findings prompt consideration of an oral microbiome-nervous system axis.Ethical review and approval of the study protocol and procedures was granted by the New Zealand Health and Disability Committee (HDEC) (ref: [details omitted for double-anonymized peer review]) and the study was registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR), registration number [details omitted for double-anonymized peer review]. https://www.anzctr.org.au/ Written consent was obtained from all participants prior to undertaking the requirements of the study.