Irritable bowel syndrome increases the risk of developing both first-onset and chronic orofacial pain, including temporomandibular disorders and burning mouth syndrome, according to a systematic review of 22 observational studies.
- IBS is linked to higher risk of chronic orofacial pain and TMD with moderate certainty
- GERD and PCOS also show associations with TMD, though evidence quality is lower
- Findings support screening for overlapping pain conditions in orofacial pain patients
How this compares to prior research
Previous reviews have noted associations between orofacial pain and other chronic pain conditions, but uncertainty remained about the timing of these relationships and the strength of evidence. This systematic review specifically examined whether gastrointestinal, gynecological and urogenital conditions act as predisposing or perpetuating factors for orofacial pain. The authors aimed to clarify temporality, effect sizes and evidence certainty that earlier work had not fully established.
Chronic pain condition prevalence trends, global data, 1980–1989
Key findings
- Longitudinal studies show irritable bowel syndrome increases risk of first-onset and chronic orofacial pain including temporomandibular disorders and burning mouth syndrome with moderate certainty
- Cross-sectional evidence reveals moderate associations between gastroesophageal reflux disease and temporomandibular disorders, and large effects between polycystic ovary syndrome and temporomandibular disorders
- Interstitial cystitis, gastritis, inflammatory bowel disease and endometriosis show associations with orofacial pain but are supported by limited low-certainty evidence
What this means in practice
- Tell your dentist or doctor if you have IBS, GERD or PCOS when seeking treatment for jaw pain or facial pain
- Consider consulting multiple specialists if you have both digestive problems and chronic facial or jaw pain
- Ask about screening for overlapping pain conditions if you experience persistent orofacial pain
Frequently asked questions
What are chronic overlapping pain conditions?
Chronic overlapping pain conditions are multiple pain disorders that occur together, including gastrointestinal, gynecological and urogenital conditions that can co-exist with orofacial pain.
Does having IBS mean I will develop TMD?
IBS increases the risk of developing temporomandibular disorders, but does not guarantee it will occur. The review found moderate certainty evidence of increased risk.
Should doctors screen for gut problems in TMD patients?
Yes, findings support considering gastrointestinal and other overlapping pain conditions when evaluating orofacial pain patients, suggesting multidisciplinary approaches to management.
Key terms explained
Temporomandibular disorders (TMD)
Pain and dysfunction affecting the jaw joint and muscles that control jaw movement.
Chronic overlapping pain conditions (COPCs)
Multiple chronic pain disorders occurring together in the same person, often involving different body systems.
Irritable bowel syndrome (IBS)
A digestive disorder causing abdominal pain, bloating, and changes in bowel habits without structural damage.
Source: Are gastrointestinal, gynecological and urogenital chronic overlapping pain conditions (COPCs) predisposing or perpetuating factors for orofacial pain (OFP)? A systematic review. · DOI: doi: 10.17219/dmp/214902