The gut-masticatory muscles-temporomandibular joint pain axis-a scoping review

Orofacial pain has become the most common debilitating disease resulting in high healthcare costs, and compromising the quality of life, speech, aesthetics and masticatory function of those affected. As its aetiology is multifactorial and as the treatment involves a multidisciplinary holistic approach, arriving at a confirmative diagnosis is challenging. Numerous studies have been published that support the bidirectional link between gut health and other organs like the cardiovascular system, respiratory system, neurological and hormonal. Recent studies indicate a potential link between gut microbiota dysbiosis and chronic orofacial and temporomandibular joint (TMJ) pain. In this review, we enumerate the link between the metabolites released by the gut bacteria and how they regulate the pain mechanism of various types of orofacial pain like chronic, neuropathic and inflammatory in the orofacial and TMJ regions. We also discuss the potential link between pain and gender predisposition. Further, we review the recent non-invasive therapeutic options which can be put forth to use for treating orofacial and TMJ pain.