Personal Care and Hygiene

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Personal Care and Hygiene

Hygiene is more than just being clean. It is defined as the many practices that help people be and stay healthy. Practicing good personal hygiene is smart for two reasons. First, it helps prevent people from catching and spreading illness and disease. Second, it helps people feel good about themselves and their bodies. In American society, cleanliness is an important issue; poor hygiene is seen as unacceptable and unhealthy.

Good hygiene includes thoroughly and regularly washing one's body (especially hands), washing one's hair, brushing and flossing teeth, and caring for gums. These grooming habits will reduce the threat of bacteria that constantly reside on the body. While a certain amount of bacteria are harmless, and even beneficial, to the body, a build-up of bacteria can harm a person's health.

As children grow older, their bodies go through a number of changes. While good hygiene is important for everyone at any age, it can require greater care at the onset of puberty. When puberty arrives (usually between the ages of eight and sixteen), it means the body is becoming sexually mature. Hormones, certain chemicals made by one's body, produce both physical and emotional changes. It is the physical changes that require greater attention when it comes to hygiene. For a young girl or boy, this means taking more time and care cleaning one's body, especially the sexual organs, dealing with acne, bad breath, and a stronger body odor, as well as doing more to prevent cavities and gum disease.

This chapter will focus on all aspects of hygiene and the ways in which a person should care for the skin, hair, nails, eyes, ears, genitals, teeth, and gums.

BODY BASICS

The best way to keep the body clean and free of infection is to wash on a daily basis. This means taking a shower or a bath and using soap and hot water to wash away the bacteria that build up over the course of the day. This also means washing one's hands several times a day. Since the hands touch many foreign objects as well as many familiar objects (like one's nose, mouth, and eyes), washing hands, especially after going to the bathroom, will prevent harmful bacteria from damaging one's health.

Washing Hands

One of the best ways to prevent bacteria from spreading and catching the common cold is to wash one's hands. While this procedure may sound simple, medical experts say that most people don't wash their hands properly or often enough.

Body Basics: Words to Know

Abscess:: When pus from a tooth infection spreads to the gums.
Antibiotic:: A chemical substance that can stop the spread of bacteria.
Anus:: An opening in the body through which solid waste is expelled.
Bacteria:: Tiny living things that have only one cell; some bacteria can cause disease.
Bladder:: An organ that holds urine.
Bonding:: Attaching a material to the surface of a tooth for cosmetic purposes.
Circumcision:: The removal of the foreskin from the glans of the penis.
Cuticle:: The skin surrounding the nail.
Electrologist:: A professional trained to perform electrolysis, or the removal of hair using electric currents.
Enamel:: The hard outer surface of the tooth.
Epidemic:: The rapid spreading of a disease to many people at the same time.
Fluoride:: A chemical compound that is added to toothpaste and drinking water to help prevent tooth decay.
Fungus:: A type of plant that has no flowers or leaves and isn't green in color (a mold is a kind of fungus).
Genitalia:: The reproductive organs.
Gingivitis:: An inflammation of the gums that is the first stage of gum disease.
Gland:: A part of the body that makes a fluid that is either used or excreted by the body; glands make sweat and bile.
Halitosis:: Chronic bad breath caused by poor oral hygiene, illness, or another condition.
Hangnail:: Loose skin near the base of the nail.
Hormones:: Chemicals produced by the body that regulate various bodily functions.
Hypoallergenic:: Unlikely to cause an allergic reaction.
Infection:: A disease that is caused by bacteria.
Intestinal:: Having to do with the intestine, the part of the body that digests food.
Keratin:: A tough protein produced by the body that forms the hair and nails.
Menstruation:: Monthly shedding of the lining of the uterus in females.
Parasites:: Any plant or animal that lives on or in another plant or animal and gets food from it.
Periodontal disease:: Gum disease, the first stage of which is gingivitis.
Pinna:: Outer part of the ear; part of the ear that is visible.
Plaque:: A sticky film of bacteria that grows around the teeth.
Pores:: Small openings in the skin.
Protozoan:: One-celled organism that can cause disease in humans.
Puberty:: The onset of sexual maturation in young adults.
Sebum:: An oily substance that lubricates the hair shaft.
Sterilization:: A process that makes something free of living bacteria.
Toxin:: A poison made by a germ.
Urethra:: The tube from the bladder to outside the body through which urine is expelled.
Vaccine:: A substance made up of weak bacteria and put into the body to help prevent disease.
Vagina:: The female canal that leads from the cervix (or opening of the uterus) to the vulva (or the external female genitalia).
Veneer:: A covering, often made of porcelain, that is placed over a tooth that is damaged or for cosmetic reasons.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that people wash their hands:

before and after eating
after touching or playing with pets and other animals
after sneezing, coughing, or blowing one's nose
after going to the bathroom
after touching trash or putting out the garbage
before and after treating a cut or wound

In addition, the way people wash their hands is not always effective. For example, it's necessary to use soap and warm water, rub one's hands together vigorously, wash the front and back of the hands and the wrists, as well as under the fingernails, and then rinse. It's also recommended that the water be left running during the drying process so one can use a paper towel to turn off the faucet. In fact, a study done by Purdue University in 1997 reported that a group of children who followed a rigorous hand-washing plan greatly reduced their number of colds.

Controlling Body Odor

When a boy or girl begins to go through puberty, the body will produce more perspiration because sweat glands, some of which are located near the underarms, become more active. More perspiration means a different type of body odor, one that is stronger and similar to an adult's. Daily bathing and showering are enough to control body odor, but many people go above and beyond just washing and use different types of hygiene products that will keep the body smelling and feeling fresh.

DEODORANTS AND ANTIPERSPIRANTS. Deodorants and antiperspirants come in many varieties. Deodorants work to cover up the body odor, while antiperspirants work to control, or dry up, perspiration. Many products now contain both a deodorant and an antiperspirant. These products come as aerosol sprays, roll-ons, sticks, creams, and even crystals. Different people prefer to use different products, and the companies that make the products will advertise specific types of deodorants and antiperspirants for men and women. This is because men and women have different body chemistries. However, these products all tend to work the same way.

PERFUMES, COLOGNES, AND SCENTED SOAPS. Many people also use some kind of perfume or cologne or a type of scented soap. While these products were first created as a way to mask or cover up body odor, many people now use them as a way to express their individuality. Not everyone likes to use these types of products, however, and some people prefer a more natural smell.

There are many different types of scents on the market, and some are advertised toward a younger audience. While there's nothing wrong with using a perfume, cologne, or a scented soap, it's important to be careful about irritating sensitive skin. Young skin can be more tender than an adult's skin, so it may be wise to wait a few years before experimenting with these products.

SKIN

Skin is the largest organ on the body. It has two layers: the thin outer layer is made up of dead skin cells that are constantly shed and replaced by new cells. The thick inner layer is made up of blood vessels, nerves, and hair follicles, which contain glands. The glands in the hair follicles produce an oily substance called sebum, which keeps the skin and hair from drying out. Daily washing will keep the skin on the face and other areas of the body clean by removing the dirt, oil, and dead cells before they can accumulate.

Puberty and Acne

Skin changes during adolescence. The onset of puberty means more hormones are produced. It is these hormones that trigger the oil glands in the hair follicles to release more sebum, which may eventually clog the small openings in the skin, called pores.

With more sebum being produced, it's possible for the hair follicles to become clogged because the oil can't escape from the pore fast enough to make room for new sebum. If sebum and dead cells collect in the hair follicle, a white-colored plug will form in the pore. With the pore plugged, the hair follicle will begin to swell and create a whitehead. Then, if the pore remains open, the surface of the pore may darken from a chemical process that occurs in the pore, thus creating a blackhead.

OVER THE COURSE OF AN AVERAGE LIFETIME, A PERSON WILL SHED ABOUT FORTY POUNDS OF SKIN.

HYGIENE THROUGH HISTORY

Though it may be hard to believe, bathing was not always considered a good practice. In fact, Saint Francis of Assisi, a Christian monk who was sainted by Pope Gregory IX in 1228, told people that they would best show their love for God by not bathing. People throughout Europe believed him and refused to bathe for any reason. In fact, Queen Isabella of Spain proudly declared that she had only bathed twice in her entire life.

It wasn't just Europeans in the Middle Ages (c. 450–1500) who refused to bathe. Early American colonists in Virginia and Pennsylvania restricted bathing as a way to outlaw any type of nudity. These laws were very strict about how often one could bathe. One law stated that anyone who bathed more than once a month would be sent to prison.

Because of these poor hygiene habits, many people died of disease. In the nineteenth century alone, millions of infant deaths were reported throughout Europe and America. The most common cause of death was infant diarrhea, which was caused by mothers who went to the bathroom, didn't wash their hands, and then passed on intestinal bacteria to their children.

It wasn't until two scientists in the late nineteenth century, Robert Koch (1843–1910) from Germany and Louis Pasteur (1822–1895) from France, discovered that bacteria were the cause of disease that the health crises began to improve. Because of their discovery, doctors and nurses began washing their hands before examining patients or performing surgery, and vaccines were developed that fought bacteria and saved the lives of millions of people.

An actual pimple is created when the wall of the hair follicle bursts, releasing sebum and dead cells into the skin and creating a bacterial infection. Pimples are actually infections and can produce red bumps that are sometimes filled with pus. If a hair follicle bursts deep under the skin, a more serious infection, called cystic acne, will occur.

In addition to puberty, acne can be hereditary, which means it's inherited from one's parents. Some mild skin problems can be cleared up with over-the-counter products, but more serious acne should be treated by a dermatologist (skin doctor).

TREATING ACNE. Treating mild acne generally involves using a product that helps reduce the amount of sebum and increases skin cell turnover. There are soaps, lotions, and creams that work to dry up oil and are available in the drugstore without a prescription.

Stronger treatment will usually require a prescription from a dermatologist. There are many prescription medicines, ranging from lotions to oral antibiotics that work to reduce the amount of bacteria in the skin. A dermatologist will determine the best one to treat individual problems. While acne cannot be cured, it can be treated successfully.

Basic Skin Care

Taking good care of the skin involves a few basic steps. Dermatologists recommend that a person wash the face two times a day with a mild soap or gentle cleanser. It is best to avoid washing too often, as the skin will become irritated and dry out. If too much of the skin's natural oil is washed away, the skin may become very dry and begin to itch and flake. Because the skin's natural process is interrupted, the skin may begin to produce more oil than usual, which can cause more breakouts.

Dermatologists also recommend the following for clean, healthy skin:

Use lotions only if needed, and use ones that are oil-free and water-based.
Try to identify what irritates the skin; if it's stress, try to reduce stress levels.
Leave pimples alone; picking, popping, or squeezing them will only make them worse.
Have only a dermatologist remove or extract pimples.
Try to avoid touching the face.
Keep hands clean by washing them often.
Try to stay out of the sun, and use a sunscreen every day during summer and winter.

Sun Protection

Protecting the skin from the damaging effects of the sun's ultraviolet rays is very important. Sunscreen

not only helps prevent premature wrinkles and painful sunburns that dry out the skin, it also can help reduce the risk of developing skin cancer. It's smart to use a sunscreen with a Sun Protection Factor (SPF) of 15 or above.

Applying a sunscreen fifteen minutes before exposure will also make the product more effective. If a person is spending a lot of time out-side, it's smart to reapply sunscreen every few hours, as sweat will dilute or wash away the lotion, leaving the skin unprotected. There are also some products that work while swimming, but it's always best to reapply sunscreen after swimming as well.

ECZEMA

The medical term for eczema (pronounced EX-em-a) is dermatitis. The skin develops a rash in a specific area, such as the backs of the knees. It can be confined to a small area, but then spread to a larger area on the skin. Sometimes blisters appear that swell, ooze, and scab.

While eczema isn't caused by poor hygiene, the treatment for the skin disorder is dependent on regular cleaning with soap and water. Eczema can be caused by a number of things, including contact with certain cosmetics, jewelry, plants, skin cream, and chemicals used to make clothing.

Treatment for eczema includes avoiding contact with the irritating product, as well as cleaning the area on a regular basis. A doctor may also prescribe a cream or ointment to help relieve the itching that eczema causes.

Sunscreen should be used every day because the sun can do damage even when it's cold or cloudy outside. If sunburn does occur, wet compresses and soothing lotions can help relieve the pain. If painful blisters or swelling appears, it's best to see a doctor.

Doctors also recommend avoiding tanning salons and sunlamps as they, too, can damage the skin.

Makeup

Using makeup is a personal choice. Experimenting with makeup can be fun. However, it's important to use products that are hypoallergenic (not allergy causing) to avoid irritation. In order to reduce the risk of clogged pores or acne, it's always smart to remove makeup at the end of the day with mild soap or another gentle cleanser.

If makeup irritates the skin, it's best to stop using it immediately. Sometimes, makeup can cause allergic reactions. Dermatologists also recommend that people avoid sharing makeup as it can increase the spread of bacteria.

HAIR

Just like skin, hair covers and protects the body. Hair is made up of tubes of keratin. Keratin is a tough protein produced by the body. Hair grows from roots in the skin, which are called follicles. Unlike the skin, which is a living organism, by the time a hair grows out of the follicle, it is already "dead." At the bottom of the follicle is the sebaceous gland. There, sebum, an oily substance that lubricates the hair shaft, is made.

Scalp Hair: The Hair on Your Head

Hair comes in a variety of types. Whether hair is curly, wavy, or straight depends upon the shape of the hair follicle. A flat follicle yields wavy hair while a round follicle produces straight hair. Very curly hair comes from oval-shaped follicles. As there are different types of hair, there are also different colors and different textures—thick or thin. Whatever kind of hair a person has, it is important that it be kept clean. This will help it look and smell good and prevent the development of scalp problems.

The hair on the head (and the scalp, for that matter) can be dry, oily, or normal, which is a combination of the two. These categories refer to the amount of sebum that accumulates on the scalp. Sebum gets distributed through the hair by combing, brushing, or touching the hair. When sebum accumulates at a normal level, it acts as a built-in conditioning system for the hair, keeping it soft and shiny.

The amount of sebum a person produces varies throughout his or her life. With puberty, there is a marked increase in sebum production between the ages of eleven and fifteen. From eighteen to twenty-four years of age, there isn't as much sebum being produced, and by age fifty, there is a dramatic drop-off in sebum production, which causes hair to look duller and rougher.

Most people have normal hair, which means it's neither too dry nor too oily. Those with dry hair often have chemically treated (colored, permed, or straightened) or coarse hair. While people of all ages can have oily hair, teens often have oily hair because of the increase in sebum that puberty causes.

ATHLETE'S FOOT

One doesn't have to be an athlete to get athlete's foot. Athlete's foot, or foot ringworm, describes a type of fungus infection that occurs on the feet. It usually occurs in males over twelve years of age; it is not common with young children and women.

Athlete's foot thrives in moist, damp conditions, especially when a person is wearing tight shoes and socks in hot weather. When the feet cannot breathe due to a lack of ventilation, athlete's foot can occur. It can take different forms on different people. Sometimes, the skin between the toes will peel and crack, and at other times, blisters develop on the soles and sides of the feet. In most cases, there is an itch that accompanies these other symptoms.

When athlete's foot is diagnosed by a dermatologist (a doctor that specializes in skin), a patient will usually receive an antifungal cream to treat the problem, which generally heals in a short time. The American Academy of Dermatology recommends the following steps to prevent athlete's foot.

Wash feet every day.
Be sure to dry feet thoroughly, especially in between the toes.
Only wear socks made of cotton, and change them if they get moist or damp.
Go barefoot when at home.
Try to wear sandals, and avoid tight shoes in warm weather.
If possible, use an antifungal powder in tight shoes.

Grooming hair often using a brush, comb, or pick is important as it helps distribute sebum through the hair. This will help hair look shinier and smoother. It will also prevent knots and tangles, both of which can lead to hair breaking or splitting.

Shampoo and Conditioner: Keeping It Clean and Smooth

There are shampoos available for all hair types. How often a person shampoos varies and depends upon that individual's hair type. A person with dry or extremely curly hair may shampoo less often than an individual with oily or straight hair. The key to good hair hygiene is shampooing often enough to keep hair looking and smelling clean.

Conditioners can help keep hair shiny and smooth. They also offer protection against the drying effects of styling hair with heat or using styling products that contain alcohol, which can be drying too. Just as with shampooing, how often and how much conditioner a person uses will depend on hair type and styling habits. An individual with coarse, curly hair that must be straightened with a blow-dryer each day should protect hair with a good amount of conditioner; someone with limp, oily hair may opt not to use conditioner at all.

Scalp Conditions

There are some skin and scalp problems that can develop that have no relation to how clean someone's hair is. Good hair hygiene, however, can help prevent infection.

HEAD LICE. Head lice are tiny insects, or skin parasites, that burrow into the scalp. They cause itching of the scalp, which can lead to a bacterial infection because of repeated scratching. In children, however, head lice are often barely noticeable. Head lice are spread through personal contact and through sharing things such as combs, brushes, and hats. Often, the lice can make their way into a person's eyebrows, eyelashes, or facial hair. Head lice can easily turn into an epidemic (the rapid spreading of a disease to many people at the same time) at a school because children often share personal items. The problem is treatable by using a cream, lotion, or shampoo, all of which are available at pharmacies.

THE AVERAGE PERSON LOSES 80 SCALP HAIRS EACH DAY.

DANDRUFF. Dandruff, also known as seborrheic dermatitis, is a swelling of the upper layers of skin on the scalp. The first signs are a drying or a greasy scaling of the scalp. Often this is accompanied by itching. Dandruff is a condition that may be inherited, and cold weather can often make dandruff worse. Unlike head lice, dandruff is not contagious. Similarly, though, it is treatable with shampoos or solutions that are available at pharmacies.

Body Hair

The onset of puberty usually means an increase in the growth of body hair for both boys and girls. Hair will appear in the pubic area, and hair on the arms, underarms, legs, and face (for boys) will often grow thicker. While body hair does protect the skin and body, it is not necessary to a person's well-being. However, removing body hair is not necessary for good hygiene if a person bathes or showers on a regular basis.

Boys and Facial Hair

As facial hair continues to grow, many boys will opt to shave. How often that is done is really a personal choice, one that depends on how fast and thick the hair grows. It also depends on whether or not a beard, goatee, or mustache is desired. However often a man wishes to shave his face, a traditional or disposable razor with shaving cream or gel or an electric razor may be used for shaving facial hair.

Girls and Body Hair

Just as boys choose to shave their faces (or not), girls may opt to remove unwanted hair on their arms, face, legs, bikini (pubic) area, and underarms. There are many methods appropriate for getting rid of this hair. Remember that different methods are better suited to different body parts.

SHAVING. Using either a traditional or disposable razor and shaving cream, girls can shave their legs, underarms, and bikini area. Electric razors are also effective although many electric razors do not provide a very close shave. In fact, both methods of shaving will not remove hair at the root, which means hair will grow back more rapidly than a hair-removal method that does remove hair at the root.

HAIR REMOVAL: A PERSONAL CHOICE

Choosing to remove the hair on one's body is a personal choice that is often influenced by the culture in which a person is raised. Certain cultures and religions frown upon hair removal while others enthusiastically encourage the practice. For girls, this is often a more involved decision as the American media is constantly assaulting female consumers with advertisements for products that will remove "unwanted" hair on the face, legs, underarms, and bikini area. At the height of the feminist movement in the 1970s, many women gave up shaving and waxing their leg and underarm hair. Today, many women also are opting not to remove any body hair, while others choose to do so.

TWEEZING. Plucking hairs with a pair of tweezers is a safe and clean way to remove hair; however, it only removes a single hair at a time, making it a more effective method for removing hair on the eyebrow area or removing a single, stray hair.

DEPILATORIES. Depilatories are lotions, creams, and gels that chemically dissolve body hair near the root. They tend to be time-consuming and can be messy. Also, because they contain chemicals, some people may find them irritating. Depilatories are effective for removing leg and bikini hair as well as underarm hair.

WAXING. Waxing involves warmed wax that is applied to the skin. A strip of cloth is then placed atop the wax. The strip is pulled back, removing the hair at the root. This procedure is typically done in salons and can be time-consuming. Also, waxing can often be painful and irritating to the skin. However, it pulls out the root of the hair, so waxing can last up to two months. Waxing is most effective for removing hair on the arms, bikini area, face, legs, underarms, and even the back.

SUGARING. Sugaring is a hair-removal technique, similar to waxing, in which melted sugar is applied to the skin and rolled off with the hands, removing the hair in that area in the process. Like waxing, sugaring can be used for most areas of the body and the results can last for two months. Sugaring is slightly less painful and irritating than waxing can be. Sugaring is typically offered at salons that use all-natural products.

ELECTROLYSIS. This hair-removal procedure takes place in the office of an electrologist (a professional trained to perform electrolysis). Hair is destroyed permanently at the root using an electric current. A needle is placed into the skin where the hair protrudes so that electricity can destroy the hair follicle. While the effects of electrolysis are lasting, it is a time-consuming, painful, and costly procedure (as it can take a few sessions before the hair follicle is actually destroyed). This is most appropriate for small areas of the body, such as the face.

LASER TREATMENTS. Laser treatments that remove hair are expensive and the results last only two months at first. Despite this, laser treatments are growing very popular for removing hair in the leg and bikini area. Over time, with continued treatments, results can last up to six months. However, it can take hair up to three weeks to fall out so many people shave the area after receiving treatment to prevent shedding. Also, a loss of skin pigment may be experienced in people with darker skin.

TEETH

Taking good care of one's teeth is one of the smartest investments a person can make in their health, helping to ensure that the teeth will remain strong, healthy, and white for a lifetime. While many advances have been made in dentistry and in replacing teeth, nothing can ever take the place of natural teeth. They are stronger than any artificial teeth a dental professional can make. This is why it is important to care for them properly.

Dental problems can be prevented by regularly using a toothbrush and dental floss, the tools for good teeth.

Brushing

There are many important reasons to brush the teeth every day. Brushing removes the plaque (a sticky film of bacteria that grows around the teeth) that causes tooth decay, or cavities. Brushing also helps keep gums healthy and breath fresh.

To make the most of brushing, a person should choose a soft-bristled toothbrush with a shape that suits one's mouth and allows one to reach all of the teeth easily. Use a toothpaste with fluoride (a chemical compound that is added to toothpaste and drinking water to help prevent tooth decay), hold the toothbrush at a 45-degree angle against the gums, and brush back and forth in short movements. Make certain to brush the outer, inner, and chewing surfaces (or flat surfaces) of the teeth. Brushing the tongue will help remove bacteria that can cause bad breath.

Flossing

Flossing between teeth is a very important habit to acquire. Ideally, flossing should be done every time the teeth are brushed. Using dental floss removes plaque that is caught between the teeth. This will help prevent both cavities and gum disease.

When flossing, use a generous length of floss (about 18 inches or so). Wrap one end of the floss securely around one of the middle fingers. Hook the other end around the same finger on the opposite hand. Holding the floss tightly between the thumbs and forefingers, pull the floss gently between each tooth. Softly rub the floss against the side of each tooth.

Some people have difficulty handling floss, but there are many types of interdental cleaners that accomplish the same thing as floss. These include different kinds of picks and dental sticks that can be found in a pharmacy or drug store.

BRUSH CAREFULLY!

It may sound strange, but there is such a thing as brushing teeth too vigorously. Even though brushing is vital to maintaining healthy teeth, it can be harmful if you are brushing improperly. The enamel that protects the outside of your teeth is hard but it can get worn. When enamel is worn, teeth are more prone to decay. Using gentle, short strokes when brushing helps ensure that teeth don't get damaged.

Tooth Decay and Cavities

Plaque is the main cause of tooth decay, or cavities, and gum disease. When people eat, especially

foods containing starches and sugars, and they don't brush their teeth right away, the plaque bacteria in their mouths make acids. These acids then attack the enamel on the teeth. When this happens repeatedly, teeth will begin decaying. Cavities accompanied by painful toothaches can develop.

Gum Disease

Another problem that plaque causes is gum disease. Gum disease, which is also called periodontal disease, occurs when gums get infected. The first stage of gum disease is known as gingivitis. Gingivitis is the inflammation of the gums. Over time, the gums and the bone around the teeth can become weakened. This can cause teeth to fall out. When this happens, it means a condition known as periodontitis is present.

Unlike tooth decay, gum disease is not as obvious as tooth decay because it is painless. Some signs of gum disease include red, swollen, or sensitive gums, chronic bad breath, and gums that bleed while brushing the teeth. Even though gum disease usually affects adults, good oral hygiene as a young adult will help prevent this disease and protect the teeth.

Bad Breath

Bad breath, or halitosis, can be caused by gum disease, eating certain foods (such as garlic), or a medical disorder. Often, though, bad breath is the result of poor oral hygiene. When bacteria build up in the mouth, it can lead to a bad taste in one's mouth and a bad odor too. Regularly brushing the teeth as well as the tongue often helps eliminate bad breath.

How A Dentist Can Help

A visit to the dentist can remedy almost any dental ailments. In fact, visiting the dentist every six months can help prevent future dental ailments. Getting regular check-ups, including diagnostic X-rays, will help prevent the development of serious dental problems such as gum disease or abscesses (when pus from a tooth infection spreads to the gums). And getting teeth cleaned professionally at the dentist's office can help remove the build-up of plaque and tartar, both of which can cause cavities.

Just as brushing and flossing are important weapons in the fight against tooth decay, so is seeing a dentist on a regular basis.

EARS

The ears consist of three parts: the outer ear, the middle ear, and the inner ear. In terms of hygiene, people need only be concerned with the outer ear. The outer ear consists of the pinna, the part that is visible, and the ear canal that leads toward the eardrum that separates the outer ear from the middle and inner ear.

The ear canal is self-cleaning. Wax is secreted into the ear canal by glands that are found in the skin of the canal. This wax and other particles, such as dust, travel down the ear canal and are washed away or fall out to make room for new wax being made. It is not necessary to use cotton swabs to clean the ear canal. In fact, using them can harm the ear by pushing wax toward the eardrum, where it can get stuck and cause blockage or an ear infection.

While cleaning the pinna and behind the ear is good hygiene, the rest of the ear will usually take care of itself.

Removing Excess Earwax

When earwax is pushed toward the eardrum, or when an abnormal amount of wax is produced in the ear canal, sometimes it's necessary for people to have the wax removed by a doctor. Excessive earwax can affect hearing and feel very uncomfortable. A doctor will most likely perform ear irrigation in these cases. Ear irrigation is a process in which warm water is gently flushed into the ear canal so that the earwax can dislodge and rinse away with the water.

Other times, a doctor may use different methods of earwax removal. These include using a blunt instrument that has a loop on the end. This instrument is carefully inserted into the ear canal to remove the wax. Another method involves using a vacuum that is inserted just inside the ear canal and then sucks out the excess wax.

PEARLY WHITES

Each year, millions of Americans go to their dentists seeking whiter, brighter smiles. Because tooth-whiteners contain peroxide, an antiseptic, whitening is safest when it is done under the direction of a dentist rather than purchasing an over-thecounter whitening kit.

Typically, teeth are whitened by a dentist using a hydrogen-peroxide solution in a customfitted mouthguard that the patient wears while sleeping. It can take anywhere from one to two weeks to achieve the desired shade of whiteness. How white a person's teeth get, however, depends upon the shade the teeth are when bleaching is begun. Teeth with a yellow tone will bleach whiter than those with a grayish tone.

There are other methods to lighten a person's teeth, which include laser-whitening and the use of other cosmetic procedures such as porcelain veneers or dental bonding.

Swimmer's Ear

The medical term for this common ear infection is external otitis. It earned its nickname because it occurs most often during the summer, when swimming is a common activity for people. Bacteria that infect the ear canal are the main cause of swimmer's ear. If there is excessive wax lingering in the ear canal, it can trap water in the ear canal. This trapped water will soften the skin in the ear canal, which makes it more vulnerable to bacteria.

When bacteria cause an infection, the ear may swell, itch, and be painful to the touch. There may also be a discharge from the ear canal, which will affect a person's hearing. The ear canal itself will be red and swollen. For treatment, a doctor will remove the infected wax and any other particles in the ear canal, and then prescribe medicine to treat the infection.

Healthy Hearing

Having healthy ears means more than just keeping them clean. It also means caring for one's hearing. According to the House Ear Institute, about 10 percent of people in the United States suffer from some type of hearing loss. The most common cause of hearing loss is loud noise. Certain types of noises, such as gunfire or firecrackers that explode near an ear, can do sudden damage to hearing. Other types of noise, such as lawn mowers and vacuum cleaners, cause damage over a longer period of time.

EAR CANDLING

Ear candling is an alternative method of removing earwax that is practiced by some holistic healers. This method can be traced back to the Hopi Indians, a tribe located in North America. Ear candling is a process in which the unlit end of a beeswax candle is put over the opening of the ear canal. By covering the opening of the ear canal, a vacuum (an empty space with no air) is created between the opening and the eardrum at the end of the canal. When the candle is lit, the warmth of the candle loosens the earwax, and because the wax has no where to fall in the vacuum, it is drawn out toward the flame and collects at the bottom of the candle.

Most medical doctors do not approve of ear candling and believe it does not offer any benefits to the patient. Ear candling should not be done alone or without a skilled professional who is familiar with the procedure. It's important to check out the background and references of any healer who performs this procedure before having it done.

The institute has researched hearing loss among young people and found that there is more hearing loss among young people today than there was fifteen years ago. Loud music and the common use of earphones with portable radios and CD players probably have contributed to this hearing loss. Also, most live rock concerts have volumes that reach damaging levels. Wearing earplugs to concerts can help prevent hearing loss. Essentially, any situation in which a person must shout to be heard means it's too loud and hearing could be damaged. While many people like loud music, the smart thing to do is turn down the volume.

NAILS

Like hair, nails are formed by keratin. Tiny cells living at the base and side of the nail manufacture the keratin that produces nails. The cuticle (the skin surrounding the nail) protects these cells.

Keeping Nails Clean and Neat

Nails should always be kept clean and neatly trimmed or filed. Dirt and bacteria can get trapped in nails that aren't clean. As with the hands, nails are a way for bacteria to be passed from person to person. Preventing the spread of bacteria prevents the spread of illness and infection. Nails that are excessively long can, by virtue of their length, hold more dirt than shorter nails. Those with longer nails, then, need to be more diligent about keeping their nails clean. Hangnails (loose skin near the base of the nail) should be carefully trimmed with a cuticle clipper and the area kept clean to prevent infections.

EAR PIERCING

Ear piercing is a common practice among girls, and many people consider it a rite of passage. Even boys may pierce one or both of their ears at some point in their lives. Choosing to pierce one's ears is a personal decision, however, and some people decide it's not for them. If ear piercing is done, it's very important to have it done by a professional.

Some people try to pierce their own ears. Doctors do not recommend this because, without proper sterilization, a person risks injury and infection. Ear piercing professionals use an instrument called the autoclave, which completely sterilizes equipment used in the procedure. Home methods and home ear-piercing kits do not allow a person to properly sterilize the needle used to pierce the ear. An infection can cause the ear to swell and, in more serious cases, scar the earlobe.

When ears are pierced professionally, there are aftercare instructions available that help prevent infection. These instructions usually include cleaning the lobes with alcohol or mild soap two times each day. After the ears are pierced, it usually takes a full six weeks for them to heal. Don't try to change earrings before the ears have properly healed. Patience is just as important as good hygiene. Finally, when the ears are healed, always clean new earrings with alcohol before inserting them. Also, it's not smart to share earrings without cleaning them first.

People who are allergic to certain types of metals or prone to infection should think carefully or consult with a doctor before getting their ears pierced.

Manicures and pedicures (for the toenails) can help keep nails clean and well-shaped. However, when getting a manicure or a pedicure it is helpful to have a personal kit of implements (nail file, buffer, etc.) as bacteria can easily be passed from person to person when instruments are used on different people and aren't properly sterilized (to free something from living bacteria). In fact, most nail salons now insist that customers purchase their own "kit," which the manicurist can then use on the client. Even when tending to one's own nails, instruments should be carefully washed and sterilized with alcohol to prevent the growth of bacteria on any of the tools used in manicures or pedicures.

What Nails Can Tell a Doctor

Keeping one's nails healthy and clean is important as doctors and other healthcare professionals can often tell a lot about a patient when looking at the nails. Disorders ranging from cancer to kidney disease to malnutrition can often be detected by looking at a person's nails.

INGROWN TOENAIL. Toenails become ingrown when the edges of the nail grow into the surrounding skin. This occurs when a nail that is deformed grows improperly into the skin, or when the skin around the nail grows rapidly and covers part of the nail. Symptoms include redness and pain around the area. If the toenail becomes infected, the area will swell and blisters can develop. In mild cases, the ingrown toenail can be remedied with a simple trimming; however, many times medical attention is required. Wearing shoes that fit properly can prevent ingrown toenails. Also, it is important not to trim toenails too short.

PARONYCHIA. Paronychia, an infection around the edge of a fingernail or toenail, often begins from a break in the skin due to a hangnail, vigorous manicuring, or chronic irritation (from rubbing or picking). An infection of this type can be very painful as the nail area will swell (and because it's a small area, there isn't much room to swell). Bacteria or fungi can cause paronychia. Hot compresses can help relieve pain and may help drain any pus that has accumulated. Tending to hangnails, being careful and gentle when manicuring nails, and avoiding picking or rubbing the area around the nails may prevent paronychia.

CUTICLES: TO TRIM OR NOT TO TRIM

Not too long ago, if you went into a salon for a manicure or pedicure, the manicurist would push back your cuticles and cut away the excess skin. This would be done to allow for a smoother surface on which to polish the nails. Now, manicurists ask clients whether or not they wish to cut their cuticles. And there's an important reason why. The cuticle protects the integrity of the nail by "guarding" the cells that manufacture keratin, which forms the nail. If a cuticle is trimmed and becomes infected or if a cuticle is trimmed to expose a sensitive area of the nail, future growth of that nail could be compromised. Many doctors and manicurists now advise their clients not to cut their cuticles at all.

ONYCHOMYCOSIS. This fungal infection of the nails can be contracted by walking barefoot in public places or in conjunction with the development of athlete's foot. Antifungal drugs are

used to treat this disorder. Keeping nails short can help minimize discomfort. Preventative measures against onychomycosis include covering the feet when walking outside the home.

NAIL RINGWORM. With nail ringworm, a fungal infection, similar to athlete's foot, infects the newest formed part of the nail. This causes the nail to grow in thick and deformed. This is treated with antifungal drugs. Keeping hands clean, particularly after being in public places such as gyms, may help prevent the transmission of nail ringworm. Also, the use of personal manicure implements can help prevent nail ringworm.

GENITAL CARE FOR FEMALES

Many females have received the false message from society that their genitals are "dirty" and that they shouldn't talk about them. Because of these messages, which can come from media as well as parents, girls are under the impression that any smell or discharge from their vagina is abnormal. It is perfectly natural to have a slight sweet smell that is nonoffensive. A strong, foul odor indicates a possible infection. With treatment, the infection will go away and so will the strong odor. Vaginal discharge is a necessary part of the body's regular functioning. Normal discharge, usually clear to white, is part of the body's self-cleaning process. As discharge leaves the body, it takes bacteria with it, which helps keep vaginal infections at bay. Discharge is also a natural lubricant, which aids in sexual intercourse.

The genitals are complex, life-giving organs with many functions. Knowledge is a key factor in developing a healthy attitude about the genitalia and realizing that the genitals are not "dirty" and are basically just other parts of the body. Understanding the normal functions of the genitals also helps a person feel more comfortable with her body and stay healthy.

CHARACTERISTICS OF ABNORMAL VAGINAL DISCHARGE

bad odor
itching or irritation
thick, like soft cheese
creamy or frothy
strange color, such as green, gray, or yellow
bloody (not during menstruation)

Washing the Genital Area

It is important to regularly wash the genital area, including the anus, to help ward off infections and bad odor. Since the genital area is moist and warm, bacteria can grow easily. Excretions from the vagina, perspiration, and urine can build up making it even easier for the bacteria to grow. These bacteria can cause urinary tract infections (UTI's) or vaginal infections. Cleaning the genital area with a mild soap and water on a regular basis will help control the bacteria growth and limit infections.

Vaginal Infections

Vaginal infection, or vaginitis, is most often caused by sexual contact. However, poor personal hygiene can put one at greater risk of contracting a vaginal or urinary tract infection. The following are some of the most common vaginal and urinary tract infections that can be affected by poor hygiene.

TRICHOMONIASIS. Trichomoniasis, also referred to as trich or TV, is an infection caused by a protozoan called Trichomonas vaginalis. The symptoms include a discharge that is foul-smelling, frothy, and greenish-yellow; it causes severe itching, painful and frequent urination, and, sometimes, pain in the lower abdomen.

YEAST INFECTION. A yeast infection, or candidiasis, occurs when the yeast fungus called Candida albicans, which is normally found in the vagina and anus, grows above normal levels. The result is a thick, white, cottage cheese-like discharge with itching, redness, and burning.

GARDNERELLA. Gardnerella is an another bacterium that is normally found in the vagina. An infection occurs when the amount of gardnerella bacteria increases, causing symptoms such as a gray or yellow, fishy-smelling, creamy discharge and mild itching and burning. The smell may actually become worse after washing since soap reduces acidity and bacteria grow better in a less acidic environment.

URINARY TRACT INFECTIONS. Urinary tract infections (UTI's) can occur when bacteria from the anus or vagina make their way into the urethra and bladder. Urinating helps to flush some of the bacteria from the urinary tract, but sometimes the bacteria left behind can cause an infection. Sexual intercourse, wiping from back to front, or irritants used in a bath (such as bubble bath or bath salts) are common causes of UTI's. The symptoms include painful and frequent urination, burning on urination, blood in the urine, and a fever.

What to Wash

The area that a girl should be concerned with washing is the external genital area. The internal genitals have their own self-cleaning processes. The external female genital area, or vulva, has large lips called labia majora that protect the genital area. These lips have sweat glands that produce perspiration and glands that secrete oil. If a girl has reached puberty, these lips will also have hair on them.

Beneath the labia majora are smaller lips called labia minora. In some people, the labia minora are large enough that they poke through the labia majora. This is a normal occurrence. The labia minora also contain oil and scent glands. Inside the labia minora are the openings of the urethra and vagina. Urine is expelled from the urethra. The clitoris, a small, pea-like organ that is sensitive to the touch, lies in front of the labia minora. The anus, which is not considered part of the vulva, should be washed as well. It lies in back past the lip region.

The external genitalia and the anus can be washed using a wash cloth or fingers. This can be done daily in a shower or bath or standing near a sink. Special care should be taken to open the labias and wash between them. Then rinse the area with water and towel dry.

Be Sure to Wipe Properly

Besides washing the external genital area, it is important to wipe it with toilet paper after urinating or having a bowel movement. Solid body waste expelled by the anus contains bacteria that can cause vaginal and urinary tract infections. Therefore, the proper wiping method is from the front to back. This is so the bacteria from the anal area do not make their way to the vaginal and urethral area. A person should always wash her hands after going to the bathroom.

Extra Care During Menstruation

During menstruation, the lining of the uterus is shedding and menstrual blood comes out of the vagina. While menstruation can be messy, it is easily controlled with a tampon or pad. However, once the blood is exposed to the air, it can produce an odor. A strong odor should not occur unless the person does not bathe often enough. To minimize odor and staining of clothes, washing the genital area at least once a day is recommended. It is also recommended to change a tampon every four to six hours (a pad every two to four hours), which will help control the odor and the collection of blood.

In the past, women would use cloth to collect their menstrual fluid. Some would wear cloth as an outer protection; others would bundle up the cloth and place it inside their vaginas for inner protection. Today, there are sanitary products for collecting menstrual fluid that are more absorbent, comfortable, and convenient. These products include tampons and pads. Choosing the kind of protection to use is a personal choice. Some women use only pads, some use tampons during the day and pads at night, and others use solely tampons. Pantiliners, small pads, are also available for light flows, discharge, or use with a tampon.

TAMPONS. Tampons are worn inside the vagina. Both nonvirgins and virgins can use them. Tampons cannot get lost inside the body or be pushed up into the uterus (the canal—called the cervical canal—to the uterus is too small for a tampon to fit through). They are made of absorbent cotton that is either scented or unscented and have a string attached for easy removal. (The deodorant tampons may cause irritation in some women.) Tampons are meant to be used only for menstrual flow, not vaginal discharge. They can come with or without applicators. For greater protection, some women wear

pantiliners when they use tampons. Tampons should be changed every four to six hours, and not worn more than eight hours. Otherwise, bacteria can build up in the vagina, which can cause toxic shock syndrome (TSS).

TSS is a rare, noncontagious disease that can be fatal. It is caused by the Staphylococcus aureus bacterium, which produces a toxin resulting in symptoms that include a sudden high fever, vomiting, diarrhea, headache, rash that looks and peels like a sunburn, achiness, and dizziness. If a person using a tampon experiences any of these symptoms, she should remove her tampon right away and contact her doctor.

Researchers have found that the risk of contracting TSS is linked to the absorbency of the tampon. The higher the absorbency the higher the risk for contracting TSS. To judge the right absorbency, a woman should monitor the amount of blood found in her tampon after she removes it. If the tampon is completely red, a person should use a tampon with a higher absorbency; if the tampon has white areas, a person should use a tampon with a lower absorbency. A way to lower the risk of contracting TSS is to switch between using a tampon and using a pad. An easy way to do this is to wear tampons during the day and pads at night.

PADS. Pads are worn outside the body. When they were first introduced, women had to use belts and pins to keep the pads in place. The belts and pins were uncomfortable, unattractive, and sometimes showed through clothes. Pads today have adhesive strips that allow a woman to attach a pad to her underwear. Today's pads are also more absorbent, allowing them to be thinner and more effective. Some even have wings that wrap around the crotch of underwear, which gives greater protection. Pads can be unscented or deodorant. The deodorant can cause irritation in some women; however, many like the deodorant products, believing they help mask odor.

DOUCHES AND FEMININE HYGIENE SPRAYS. Douches and feminine hygiene sprays are products that work to mask or limit odor or wetness. Douches are sometimes used in the treatment of certain vaginal infections. They are liquid solutions that are squeezed into the vagina. A common solution is vinegar and water. Feminine sprays are deodorant sprays for the vaginal area. Doctors have warned that these feminine products are unnecessary (unless used for medical reasons) and can cause more harm than good. This is because douches and feminine sprays can change the natural acidic balance of the vagina, which can cause bacteria to grow and put a woman at risk for infection.

Be Aware of What to Wear and Other Precautions

Another part of good hygiene is being aware of what to wear and making sure that anything that touches the vaginal area is clean. A girl should wear cotton underwear or at least ones with a cotton crotch. Underwear should be changed daily and after it becomes soiled or wet. It should also be absorbent and well ventilated. Tight or nylon underwear, tight pants, or pantyhose (most are available with cotton crotches that help increase ventilation) cause greater perspiration, which can allow bacteria to grow. Sitting around in a wet bathing suit will also contribute to bacteria growth. Towels should not be shared because they can pass along bacteria. Toilet seats are also breeding grounds for bacteria. It is wise to cover public toilet seats with toilet paper before sitting down. Taking these precautions can help lower the risk of infection and keep the genitals healthy.

GENITAL CARE FOR MALES

It is necessary for boys to pay attention to the health of their genital area. However, like girls, boys contend with societal pressures to not talk about their genitals. They are often embarrassed to speak to anyone about any problems or questions they may have about their genitals. It is important for both boys and girls to learn about their genitals, ask questions, and practice good hygiene in order to maintain health.

Keeping the Genital Area Clean

Boys should wash their genitals every day. This includes washing the penis, the scrotum which holds the testicles, the anus, and pubic hair (if puberty has been reached) with water and mild soap. For cleanliness after urinating, the penis should be shaken gently until the few remaining drops of urine are expelled. It may be wiped as well. Following a bowel movement, the anus should be wiped. Covering public toilet seats with toilet paper is also recommended since bacteria grows easily on toilet seats. Washing hands after urinating is a must, otherwise, bacteria will be spread via the hands.

As well as washing and wiping the genitals, boys should be concerned with the kind of underwear and pants they wear. Underwear or pants should not be too tight, and they should be well ventilated to help stem bacteria growth. If underwear gets wet or soiled, it should be changed. Also, towels should not be shared since they can pass bacteria.

JOCK ITCH

Jock itch, or groin ringworm, is a fungal infection (caused by certain fungi and yeasts) that usually occurs in warm weather. It is caused by wearing tight clothes that are not well ventilated. The symptoms include redness, blisters, itchiness, and pain of the groin and upper, inner thigh area. This type of infection can easily recur if not taken care of properly. A variety of over-the-counter creams are available to remedy jock itch.

Circumcised and Uncircumcised Penises

When a boy is born, he has an uncircumcised penis. This means his penis has a foreskin, or prepuce, that covers the head of the penis, or glans. The foreskin, which is about one third of the penile skin, offers protection from irritation, urine, and fecal matter. It also has sensitive nerve endings. A common procedure of removing this foreskin is called circumcision. Some people believe removal of the foreskin helps keep the penis cleaner because the foreskin can trap excretions and possibly lead to infection or disease; others believe this is an unnecessary and unhealthy procedure and that if the foreskin is washed daily, it should not pose a problem. A circumcision can be performed at any point in a man's life, but it is commonly done a few days after birth. Whether a boy is circumcised or uncircumcised, good hygiene is important.

A boy with a circumcised penis no longer has the foreskin, so he is just concerned with washing the penis with mild soap and water. If a boy is uncircumcised, the foreskin should be pulled down daily to expose the tip of the penis, which should then be washed with mild soap and water. However, do not force the foreskin down at any time. If it is painful to pull the foreskin down (and the foreskin has already detached itself from the glans), contact a physician for advice and possible treatment. Note that it is natural for the foreskin to be attached to the glans at birth and the amount of time it remains attached can vary from days to years. The average age by which the foreskin detaches is three. If the foreskin is still attached to the glans, it should never be forcibly pulled down. Just washing around the outer part of the foreskin is appropriate until the foreskin detaches. Once the foreskin does detach from the glans, it should be pulled down and the area should be washed daily.

Pulling down the foreskin and washing the area daily is important because the area under the foreskin is not well ventilated. Dead skin and an oil-like substance (called sebum, which usually doesn't appear until puberty) can accumulate under the foreskin forming a substance called smegma. This substance is a natural lubricant between the foreskin and the glans. If smegma is not washed from underneath the foreskin, it can build up and harden. This collection can lead to infections and disease. Soft smegma that is washed away on a regular basis poses no health risks; in fact, it is beneficial for erection and sexual intercourse.