Objective: To investigate the relationship between subjective symptoms of orofacial pain and oral health-related quality of life (OHRQoL), as well as psychological distress in population-based middleaged women. Material and methods: The two study samples comprised 1059 women, 38 and 50 years old, in representative cross-sectional studies. Women with long-lasting, frequent pain or headaches, related to temporomandibular disorders (TMD), with moderate-to-high estimates were analysed in relation to the non-case group. OHRQoL was measured using the Oral Health Impact Profile (OHIP-5). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) and Sense of Coherence (SOC-13). Results: Women with orofacial pain (n ¼ 82, 7.7%) had a significantly higher mean score on the OHIP-5, HADS-A and HADS-D and a lower mean score for SOC-13. In a multivariable logistic regression, orofacial pain was statistically significantly associated with poorer OHRQoL (OR ¼ 1.2) and signs of depression (HADS-D) (OR ¼ 2.0). A higher score for SOC-13 protected from the experience of orofacial pain (OR ¼ 0.95). Conclusion: Orofacial pain was associated with poorer OHRQoL and signs of psychological distress. In interpreting the value of SOC, women with orofacial pain also appear to have a poorer adaptive capacity.