Spousal concordance and interdependence in depression among older adults: A cross-cultural longitudinal study in China, the United States, and England.

Fibromyalgia (FM) is a condition characterized by widespread pain with a pervasive high symptom severity []. A considerably higher prevalence is reported in women [, ]. The modified American College of Rheumatology diagnostic criteria (2016) take into account the presence of multiple somatic symptoms including fatigue, cognitive difficulties, and headaches []. In this context, oral symptoms are commonly described in FM, including xerostomia, glossodynia, and temporal joint dysfunction, with the prevalence of oral symptoms being as high as 70% []. It has also been noted that medications commonly employed in FM, including antidepressants and analgesics, can cause oral symptoms including dryness and bruxism []. Despite the high reported burden of oral symptoms in FM, few studies have reported on oral status in individuals with the disorder. One study reported low prevalence of identified oral lesions in FM, which did not differ from controls, despite a high symptom burden in the FM group []. We have reported our studies on contact allergy in the FM population, which demonstrated that females with FM have a higher burden of contact allergy when compared with controls, and that the pattern of contact allergy in this group appears to favor contact allergens where sensitization potentially can occur via the oral mucosa [–]. These allergens, including gold and certain flavor/fragrance substances, have also been implicated in systemic contact dermatitis, whereby systemic exposure to an allergen in a sensitized individual can give rise to cutaneous and extracutaneous symptoms such as pain in muscles and joints []. In the case of gold, this can be attributed to a low chronic release of gold from dental restorations [, ]. Manifestations of gold allergy in gold-allergic individuals upon systemic exposure to gold can include general malaise and pain [, ]. The question that arises from these studies is whether individuals with FM have a characteristic oral status that can cause a propensity to sensitization to these substances or if they have a higher burden of allergen exposure, either from oral care habits or presence of dental materials. A broader question is whether systemic contact allergy could be a contributory factor in the symptomology of FM. The aims of the current study were as follows: (1) To survey oral health in FM and compare with population controls and (2) to assess whether patterns of contact allergy are related to oral status in FM.