You might associate menopause primarily with symptoms like hot flushes. But that’s just one of dozens of symptoms, which include burning mouth syndrome and gum disease.

That’s not to mention pregnancy gingivitis, periodontal disease, which has been linked to polycystic ovarian syndrome, or even delayed tooth eruption and other dental changes among people with hyperthyroidism.

So it’s a good thing Dr Mohammad Ali, a dentist and co-founder of Emerdency, has shared the signs experts can spot in seconds which may reveal changes to your hormone levels.

These are:

This may be a sign of pregnancy, Dr Ali said. “Gums look swollen, red and bleed very easily even when brushing and cleaning are good, which can suggest that hormones are making the tissues more reactive to plaque.”

This may happen, the expert explained, because “Progesterone and oestrogen increase blood flow levels to the gum tissues and make them more reactive to plaque.”

Additionally, “Thyroid disorders can also interfere with tissue healing, so gums can become inflamed more quickly and take longer to recover.”

2) A dry mouth (xerostomia)

“If a patient’s tongue seems to be textured or sticky and saliva is low,” especially if the person’s dental hygiene is generally good, Dr Ali said dentists may begin to suspect “menopause, low oestrogen, ongoing high stress, and certain medications or medical conditions”.

He added, “Low oestrogen can reduce saliva production in many women. Saliva is key to protecting teeth, so menopausal women may notice more frequent cavities and greater sensitivity than before”.

And, he added, saliva production is linked to our parasympathetic, or “rest and digest,” system. Overproduction of stress hormones like cortisol “can disrupt these pathways and reduce saliva flow in many people.

“Dry mouth has also been linked to burning mouth syndrome, another condition linked to menopause.”

This may be linked to elevated stress levels (and the overproduction of associated hormones) as well as poor sleep, said the dentist.

“When dentists examine teeth at a check-up, they can usually see clear signs of grinding, such as tiny fractures, flat edges and chipped enamel.

“These are classic signs of clenching or grinding, which are commonly linked with chronic stress and restless sleep, although there can be other contributing factors as well.”

“Bad breath is not always about brushing routines,” Dr Ali shared.

It can also be caused by “metabolic and hormonal factors,” like insulin resistance and PCOS, which “may alter the balance of bacteria in the gut and mouth”.

Hypothyroidism, too, “lowers metabolic rate and slows saliva production, letting odour-causing bacteria thrive,” he added, while “elevated ketones from blood sugar imbalance,” sometimes caused by insulin issues, “can also change breath smell”.

Stomach acid doesn’t just cause heartburn – it can wear your teeth down, too.

And, Dr Ali said, some hormonal shifts can create acid reflux. “Hormones can contribute to acid reflux, especially progesterone in pregnancy and stress hormones such as cortisol during extreme stress.

“Progesterone relaxes the lower oesophageal sphincter, which can increase reflux. Stress hormones such as cortisol can increase stomach acid and make reflux symptoms worse in susceptible people.”

“Drops in oestrogen are thought to weaken mucosal barriers and make tissues more prone to irritation,” which could lead to more ulcers in eg menopause and perimenopause.

And, the dentist added, “persistently raised cortisol can interfere with the activity of immune cells that look after wound repair,” meaning stress may prevent your sores from healing as quickly as usual.

“When hormones are out of balance, small injuries in the mouth may take longer to heal, and ulcers may appear without any clear trigger.” Autoimmune conditions may slow the healing process, too.

“People are often surprised by how much their mouth can hint at what is going on in the rest of the body. As a dentist, I cannot diagnose hormone conditions from your teeth alone, but I can spot patterns that suggest it is worth speaking to your GP or practice nurse,” Dr Ali ended.

He recommended keeping a diary of your symptoms, asking a GP for a hormone or blood test if symptoms continue, visiting a dentist if you have any dental concerns, increasing your hydration if you have a dry mouth, and using a fluoride toothpaste to protect your enamel.