Could the COVID-19 Vaccine Cause Burning Mouth Syndrome or Tongue Issues?

February 18, 2024

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The COVID-19 pandemic changed life as we knew it. An unfortunate but necessary safety measure was the creation of COVID-19 vaccines to help end the pandemic. As with any new medication, questions emerged about potential side effects from the COVID-19 vaccines. This article examines if the COVID-19 vaccine could cause burning mouth syndrome or other tongue issues.

What is Burning Mouth Syndrome?

Burning mouth syndrome (BMS) refers to chronic mouth pain without an obvious cause. The hallmark symptom is a painful, burning sensation affecting the tongue, lips, gums, palate, or entire mouth. Despite its name, BMS is not always characterized by a hot or scalded feeling. Some describe it as stinging, tingling, or numbness in the mouth.

While it can affect anyone, BMS is most common in middle-aged and elderly women going through menopause or post-menopause. Up to 18% of postmenopausal women experience BMS. Estrogen deficiency may play a role.

Doctors don’t know exactly what causes BMS. It likely involves damaged nerves in the mouth. Stress, nutritional deficiencies, oral yeast infections, acid reflux, hormone changes, and nerve damage from conditions like diabetes or Sjögren’s syndrome may contribute. Sometimes, no trigger is found.

Symptoms of burning mouth syndrome include:

  • Burning, stinging, or numb sensation in the mouth
  • Dry mouth or altered taste
  • Tongue pain or sensitivity
  • Tingling lips or gums
  • Symptoms that come and go or vary in intensity
  • Mouth pain with no obvious signs of disease
  • Symptoms worsening as the day goes on
  • Difficulty eating, drinking, or swallowing due to pain

BMS significantly reduces one’s quality of life. The constant oral discomfort makes it difficult to speak, eat, swallow, and engage in other daily activities. Up to 70% of those with BMS report feeling depressed. Getting to the root cause is key.

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Could the COVID-19 Vaccines Cause Burning Mouth Syndrome?

When the COVID-19 vaccines first debuted, health organizations meticulously tracked side effects. Burning mouth syndrome was not one of the initial adverse events reported.

However, as more people got vaccinated over 2021-2022, some began reporting post-vaccination mouth and tongue issues:

  • case report described a 52-year old woman developing burning mouth syndrome, including tongue pain and dry mouth, after her second Pfizer BioNTech dose. Her symptoms began the day-of vaccination and lasted 6 months until finally resolving after treatment.
  • study found 7 individuals developed burning mouth symptoms starting 1-14 days after COVID-19 vaccination. Their average pain intensity was 6.5 out of 10. Most people recovered fully within 3 months after using clonazepam, gabapentin, or aluminum hydroxide mouth rinses.
  • case series reported 4 people experiencing new-onset burning mouth pain around the time of their second mRNA vaccine. Each achieved relief using topical therapies like lidocaine, antifungals, steroids, and tricyclic antidepressants.
  • One paper described a 66-year old woman with immediate burning tongue pain after her first AstraZeneca vaccine. She continued feeling significant discomfort at 4 months follow-up.

These initial reports cannot prove cause-and-effect but indicate some people may develop burning mouth or tongue discomfort in proximity to COVID-19 vaccination. Researchers hypothesize this phenomenon might result from:

  • The body mounting an inflammatory reaction against vaccine components
  • Stress, anxiety, or nocebo effects (negative expectations) about vaccination triggering oral nerve issues
  • Subclinical conditions like vitamin deficiencies or candidiasis becoming exacerbated

One study found nearly 16% of those complaining of side effects after COVID-19 vaccines had oral or facial symptoms. The most common included general mouth pain, gum issues like bleeding or swelling, blisters, mouth ulcers, bad breath, and taste changes.

A few factors suggest at least a subset of these vaccine-associated mouth complaints could represent burning mouth syndrome:

First, their timing often correlated closely with vaccination, making it plausible (though not certain) that the vaccine served as a trigger.

Second, several symptomatic people had no prior history of chronic oral disease yet developed stubborn burning, tingling or numbness resembling BMS.

Third, many cases responded well to typical BMS treatments like topical benzodiazepines, tricyclic antidepressants, alpha lipoic acid, or antifungals. This aligns with how doctors approach idiopathic BMS.

So in summary, while burning mouth syndrome is not proven to be a common or direct side effect, emerging reports indicate some individuals might experience prolonged mouth discomfort or atypical pain after COVID-19 vaccination. Providers should listen openly to patients’ symptoms rather than dismissing complaints solely because a condition is not “officially” linked to a treatment.

What About COVID Tongue or Other Lingual Issues?

Beyond burning mouth syndrome, might the COVID vaccine specifically harm the tongue or cause other tongue-centric conditions? This remains up for debate, but again, we have clues:

  • In medicine, “COVID tongue” refers to tongue symptoms people experience in association with COVID-19 infection rather than vaccination. Data shows 5-6% of those ill with COVID develop tongue pain, swelling, discoloration, ulcers, or sensory changes. Why might this happen? Experts propose the SARS-CoV-2 virus causes inflammation and microcirculation issues in tongue tissue similar to other organ damage.
  • However, a few reports associate unusual tongue reactions specifically with administration of COVID-19 vaccines:
    • case report told of a 44-year old woman developing severe tongue swelling requiring emergency care three days after her initial AstraZeneca shot.
    • Researchers described two women who experienced painful tongue blistering and ulcers shortly after mRNA vaccination along with mouth discomfort. Their sores took 8 to 28 weeks to fully heal.
    • study included a 33-year old patient with immediate stinging tongue pain and sensitivity after her second Moderna dose. Her discomfort lasted months until prescription treatment.While anecdotes, these examples illustrate that in very rare cases, components of the COVID vaccines might spark local reactions or inflammation involving the tongue.

Experts also flag a theoretical risk around mRNA platforms provoking oral lichen planus (OLP) flares. OLP causes chronic white lacy patches, redness, swelling, and pain affecting the inside of the cheeks, gums, or tongue. Research indicates OLP attacks often link to the immune system reacting to specific triggers. Expert analysis speculates mRNA vaccines could activate immune cells and potentially exacerbate OLP among susceptible patients. However, this idea remains speculative. No studies have systematically analyzed if those with oral lichen planus suffer more frequent flares after COVID-19 vaccination compared to baseline. This concept requires proper investigation.

Tips to Prevent or Manage Oral Pain After Vaccination

While severe reactions seem very rare, some data suggests certain people might develop tongue, mouth, or dental problems in proximity to receiving COVID-19 vaccines. What practical steps can you take to avoid these situations or find relief if they occur?

Before vaccination:

  • Care for any underlying oral health conditions. See your dentist to treat cavities, gum disease, ill-fitting dentures, etc. Proper oral hygiene and moisture helps prevent issues like mucosal irritation or candidiasis.
  • Check for vitamin deficiencies. Correct any deficiencies in iron, vitamins B1, B2, B3, B6, B12, folate, or zinc which could make your mouth more vulnerable to nerve dysfunction or inflammation. Ask your doctor to run bloodwork if unsure.
  • Address sources of anxiety, fatigue, and tension. Burning mouth syndrome often links to reactive stress mechanisms. Minimize life, financial, or health stressors which can amplify pain perception. Get good sleep.
  • Avoid alcohol, spicy/acidic foods, irritating oral products. Curb intake of foods, drinks, cigarettes, vapes, mouthwashes, or toothpastes which could dry out your mouth or spark localized irritation and pain.

After vaccination:

  • Use analgesics if needed judiciously. For severe discomfort, nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen or acetaminophen may help reduce inflammation affecting mouth nerves or tissues. However, avoid long-term use given medication risks.
  • Rinse with baking soda, salt water, aloe vera, or antacid solutions. Gentle, soothing oral rinses can moisten tissues and calm nerve pain. Swish, rinse, and spit – don’t swallow large amounts.
  • Try OTC topicals. Localized numbing gels, rinses, lozenges or sprays with lidocaine or benzocaine may temporarily relieve burning mouth discomfort. Ensure proper dosage and contact your doctor if problems persist over 2 weeks.
  • Ask your provider about prescription therapies. For stubborn burning tongue or mouth pain, oral steroids, muscle relaxants, tricyclic antidepressants, anticonvulsants, or antifungals might provide relief where OTC remedies fail. But these carry greater risks requiring clinician oversight.

See your doctor promptly if you experience odd mouth symptoms that don’t improve or spread after COVID vaccination. While short-lived sensitivity is expected, immediate swelling, ulcerations, intense bleeding, or trouble breathing constitutes an emergency. Monitoring for rare complications remains vital even as these inoculations prove largely safe for society.

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Frequently Asked Questions

Is there proof the COVID-19 vaccines cause burning mouth syndrome?

While unable to establish definitive causation yet, emerging reports show some people develop burning mouth symptoms shortly after COVID-19 shots without other explanations. We need more data to confirm if vaccination provokes BMS flares versus other factors playing a role. Either way, doctors successfully treated most documented cases using standard BMS protocols like nerve medications.

How might COVID vaccine ingredients harm tissues in the tongue or mouth?

Researchers theorize vaccine components could spark localized inflammation or irritation affecting mouth lining, glands, nerves and structures – especially if someone has underlying vulnerabilities. The mRNA vaccines also activate robust immune reactions which could exacerbate conditions involving abnormal immune attacks on oral tissues (like lichen planus). But proof remains limited thus far.

Does the type of vaccine impact risk of mouth or tongue issues?

So far, instances of burning mouth syndrome, painful glossitis, or mucosal reactions occurred in people receiving mRNA (Pfizer, Moderna), viral vector (Astrazeneca, J&J), and adjuvanted protein subunit (Novavax) COVID vaccines. No single vaccine type appears riskier although sample sizes are small. We need more comparison data between formulations.

How long might tongue or mouth symptoms last after COVID vaccination?

Among published cases, duration of burning mouth, tongue pain and other oral effects widely ranged from days up to 8+ months post-vaccination. Most people saw gradual resolution by around 3 months. How long discomfort persists likely depends on contributing factors like one’s pain perceptions, tendency to form scar tissue, and whether any treatment is pursued.

Who may be at increased risk of mouth issues following COVID immunization?

It’s difficult to pinpoint specific risk factors for oral complications since these events are rare overall. However, people prone to exaggerated physical reactions or very sensitive nerve perceptions could conceivably be more vulnerable. Having a history of chronic pain, fibromyalgia, migraines, or psychiatric issues may play a role according to some experts. Certain immune or endocrine conditions also elevate general side effect risk.

In Conclusion

  • A small number of people report developing burning, tingling, or soreness in their mouth or tongue regions following COVID-19 vaccination. While unable to establish definitive causality yet, the symptom timing suggests a possible trigger effect in some cases.
  • Leading theories on how COVID shots could instigate mouth discomfort include through inflammatory responses, exacerbating undiagnosed conditions, nocebo effects, or idiosyncratic reactions in susceptible individuals.
  • Most documented instances of oral pain after vaccination eventually resolved on their own or through standard interventions like topical lidocaine, nerve medications, or dental work.
  • To minimize side effect risk, optimize precautions like managing health anxiety about vaccination, stabilizing any chronic illnesses, avoiding unnecessary drugs/toxins around the time of your shots, and promptly reporting concerning reactions to your provider.
  • Overall, significant adverse effects from COVID immunizations remain very rare. Continued tracking of longer-term safety data can help crystallize if select individuals are prone to developing burning mouth syndrome or similar tongue issues following vaccination.

Stay vigilant but avoid catastrophizing limited reports. The unequivocal data shows lifesaving protection against COVID-19 disease far outweighs potential downsides for most people able to get inoculated.

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