Research involving 165 participants opens a new avenue for understanding migraine, while expert cautions that findings do not establish cause and effect
Ras Al Khaimah, UAE: Bacteria living in the mouth may be associated with how frequently people experience migraine, according to emerging research highlighted by Dr. Nima Sabzchamanara, General Dentist at RAK Hospital. He says the findings offer an intriguing perspective on the relationship between oral health and neurological conditions, while emphasising that they do not prove that oral bacteria cause migraine.
A study published in Neurology: Neuroimmunology & Neuroinflammation examined the oral and gut microbiomes of 165 participants, including people with episodic migraine, chronic migraine and healthy individuals. Researchers found differences in the oral microbiome—the community of microorganisms living in the mouth—between the groups, with several types of bacteria associated with the number of headache days experienced over a 30-day period.
Commenting on the findings, Dr. Nima Sabzchamanara, General Dentist at RAK Hospital said: “When we think about migraine, we usually think about the brain, stress, sleep, hormones or certain foods. The mouth is rarely part of that conversation. This research encourages us to explore whether oral microorganisms may also be connected with migraine frequency, while recognising that an association does not establish a direct cause.”
The mouth contains a diverse community of bacteria that interact with food, saliva and oral tissues. These microorganisms can produce or modify biological compounds, prompting researchers to investigate their potential connections with processes elsewhere in the body.
One possible pathway involves nitrate metabolism. Certain oral bacteria convert nitrate into nitrite, which can subsequently contribute to the formation of nitric oxide, a molecule involved in blood-vessel regulation, inflammation and pain signalling. Although nitric oxide has been studied in relation to migraine, the role of oral bacteria in this pathway requires further investigation.
Dr. Sabzchamanara noted that his clinical experience has also prompted an interest in the relationship between oral health and recurrent headaches.
“I have had patients come to me primarily because of recurrent headaches, and during the dental examination we have also found significant gum inflammation or signs of habits such as clenching,” he said. “These cases have made me more interested in the relationship between oral health and neurological symptoms, although I would be very cautious about assuming a direct cause-and-effect relationship.”
He stressed that the research should not be interpreted as evidence that improving oral hygiene or undergoing dental treatment will prevent migraine. The findings do not establish whether changes in oral bacteria contribute to migraine, whether migraine-related factors alter the microbiome, or whether other factors influence both.
“Brushing, flossing and maintaining oral health remain important, but the current evidence does not support presenting them as a way to prevent migraine,” Dr. Sabzchamanara added. “There are currently no established dental treatments aimed at altering the oral microbiome specifically to prevent migraine, and patients should not change their prescribed migraine medication based on these findings.”
Larger and longer-term studies are needed to determine whether the microbial patterns identified can be reproduced across different populations and whether changes in the oral microbiome influence migraine frequency. If future research establishes a causal relationship, the findings could potentially contribute to more personalised approaches to assessing and managing migraine.
“For now, the message is that oral bacteria may be associated with how often people experience migraine, but whether they contribute to it remains unanswered,” said Dr. Sabzchamanara. “This is an important question for further research and another reminder that the mouth should be considered within the wider context of overall health.”
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