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Whether you’re in Los Angeles, California or Teresina, Brazil, or Bordeaux, France a hospital is a place you go to get better, to recover from injury or sickness, to heal. Whatever brings you there, the last thing you expect is to leave worse off than when you showed up.

Unfortunately, a lot of people do. We’ve all heard horror stories about botched surgeries and staph infections, but according to researchers in Brazil and France, you’re better off worrying about your teeth.

That’s because even after just 14 days in a hospital, patients in two separate studies conducted halfway around the world from one another both came back, overwhelmingly, with seriously deteriorated oral health.

The more recent study, in Brazil, tested 162 elderly patients, while the French researchers looked at 159. In both cases, the results suggest a serious gap in oral health services hospitals.

Brazilian researchers found their patients to present with significantly elevated levels of both plaque and other gingival indicators. In the French study, meanwhile, 140 of 159 patients needed subsequent dental care — 77, researchers suspect, because of malnourishment.

In some senses, the results make sense. Hospitals are busy places, where urgent concerns crop up regularly and even the usual schedule is frantic. Many are understaffed, and in all, workers have to deal with a constantly shifting list of demands jostling for priority and their attention. In that setting it’s only natural for some things to fall by the wayside.

The French study suggests that other factors may play an important role, as well — malnourishment has been correlated to poor dental health, among other things – but if it is indeed the case that hospitals are neglecting their patients’ oral health in lieu of other, more seemingly pressing concerns, then there is an important gap in education that needs to be addressed.

Not only can subsequent dental bills cost their patients thousands, but dental health has been strongly correlated to a number of serious health concerns, including heart disease, diabetes, and general infection.

It’s disturbing enough to think what effects this sort of exposure could have on an already vulnerable elderly population like the one included in the studies — as a rule, elderly people have poorer dental health than the general population. But even a healthy person should not be leaving their teeth and gums unattended for that long.

The inflammation that can come as a result may even lead to low effectiveness of treatment in the hospital itself. Ignoring patients’ mouths, in other words, may just allow the leave the rest of them open to attack.

As research builds connecting dental health to overall health in general, our understanding of medical treatment will need to change as a result. There’s already plenty to suggest that teeth need to be included as part of any holistic approach to medicine.

In the meantime, the next time a loved one spends time in a hospital bed, be sure to bring them floss along with all those flowers.

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