“as a bonus,” she seized the opportunity and started to assess oral health in a new way, adapting a World Health Organization survey into a tool that captured dental status along with patient history, self-care habits, diet and psychosocial impacts. ones: rate the health of your teeth and rate the health of your gums. “Those lined up beautifully with the rest of the survey,” she says. “It gave us confidence that the tool captured the real picture.” Among the clearest findings was an association between oral health and migraine. “Poor oral health meant women were more likely to have migraine, and to land in the frequent or chronic migraine categories,” Dr. Erdrich says. In the cohort, women with fibromyalgia also had generally poorer oral health (and more had migraine) than those without the condition. The oral microbiome findings added a new layer of insight. When Dr. Erdrich’s team examined the samples, they saw that certain bacterial species consistently tracked with pain scores, even after applying stringent statistical corrections to eliminate spurious results. In women reporting higher levels of body pain, several organisms stood out. These included Parvimonas micra; Solobacterium moorei, a hydrogen-sulfide–producing bacterium long associated with halitosis; Dialister pneumosintes; and Fusobacterium nucleatum, a pathogen already well known for its role in periodontal disease. Each of these bacteria have a reputation for thriving in low-oxygen environments such as beneath the gumline, exactly the kinds of conditions created by inflamed or poorly maintained tissues. The associations became even more intriguing when the team turned to migraine data. Here, Mycoplasma species emerged as strongly linked to migraine pain. “The oral health component wasn’t part of the initial research question,” she said. “But once we had that data, we started to see interesting connections between oral health, the oral microbiome and pain.” Dr. Erdrich’s research followed 168 women, two-thirds of whom had fibromyalgia and some women from both the control and the experimental groups suffered from migraine. Participants completed validated measures of pain, and headache, alongside an oral health survey. Among other questions, she also used two validated Among the clearest findings was an association between oral health and migraine. Poor oral health meant women were more likely to have migraine, and to land in the frequent or chronic migraine categories. 27 Issue 6 | 2025 | Issues and People
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