Hygiene Overview

• According to the World Bank, hygiene promotion is the most cost-effective health action to reduce disease.
• As of 2020, 2.3 billion people lacked basic hygiene services (handwashing facility with soap and water), and 1.6 billion people had access to handwashing facilities that lacked water or soap.
• Worldwide, 70% of people used basic hygiene services in 2020.

Hand Hygiene

• Research shows that washing hands with soap and water could reduce deaths from diarrheal disease by up to 50%.
• Researchers estimate that if everyone routinely washed their hands, 1 million deaths a year could be prevented.
• A large percentage of foodborne disease outbreaks are spread by contaminated hands. Handwashing can reduce the risk of foodborne illness and other infections.
• Handwashing can reduce the risk of respiratory illnesses, like colds, in the general population by 16–21%.
• The use of an alcohol-based hand sanitizer in U.S. classrooms reduced absenteeism due to infection by about 20% overall among 16 elementary schools and 6,000 students.
• Handwashing education in the community:
  • Reduces diarrheal illness in people with weakened immune systems by 58%
  • Reduces absenteeism due to gastrointestinal illness in schoolchildren by 29–57%

Face and Body Hygiene

• More than 50% of healthy people have Staphylococcus aureus living in or on their nasal passages, throats, hair, or skin. Within the first 15 minutes of bathing, the average person sheds 6 x 106 colony forming units (CFU) of Staphylococcus aureus. Showering before entering recreational waters (such as pools) prevent the spread of germs by reducing the microbial load.
• The average individual swimmer contributes at least 0.14 grams of fecal material to the water, usually within the first 15 minutes of entering. Showering with soap before swimming helps stop the spread of germs by removing fecal material from the body.
• Trachoma, the leading cause of preventable blindness worldwide, is related to the lack of facial hygiene. An estimated 41 million people suffer from active trachoma, and nearly 10 million people are visually impaired or irreversibly blind as a result of trachoma.
• Inadequate contact lens hygiene, such as failure to properly disinfect lenses, increases the risk of acquiring the eye infection Acanthamoeba keratitis.
• The spread of pinworms can be reduced by proper hygiene, including clipping nails and showering children immediately after they wake in the morning.

Handwashing is one of the best ways to protect yourself and your family from getting sick. Learn when and how you should wash your hands to stay healthy.

How Germs Spread

Washing hands can keep you healthy and prevent the spread of respiratory and diarrheal infections from one person to the next. Germs can spread from other people or surfaces when you:

• Touch your eyes, nose, and mouth with unwashed hands
• Prepare or eat food and drinks with unwashed hands
• Touch a contaminated surface or objects
• Blow your nose, cough, or sneeze into hands and then touch other people’s hands or common objects

Key Times to Wash Hands

You can help yourself and your loved ones stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs:

• Before, during, and after preparing food
• Before and after eating food
• Before and after caring for someone at home who is sick with vomiting or diarrhea
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• After touching an animal, animal feed, or animal waste
• After handling pet food or pet treats
• After touching garbage

The guidance for the list of key times to wash hands was developed based on data from a number of studies. There can also be other times when it is important to wash hands.

To prevent the spread of germs during the COVID-19 pandemic, you should also wash your hands with soap and water for at least 20 seconds or use a hand sanitizer with at least 60% alcohol to clean hands BEFORE and AFTER:

• Touching your eyes, nose, or mouth
• Touching your mask
• Entering and leaving a public place
• Touching an item or surface that may be frequently touched by other people, such as door handles, tables, gas pumps, shopping carts, or electronic cashier registers/screens

Follow Five Steps to Wash Your Hands the Right Way

Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals.

Follow these five steps every time.

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.

3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

4. Rinse your hands well under clean, running water.

5. Dry your hands using a clean towel or air dry them.

Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water.

How germs get onto hands and make people sick

Feces (poop) from people or animals is an important source of germs like Salmonella, E. coli O157, and norovirus that cause diarrhea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of germs can get onto hands after people use the toilet or change a diaper, but also in less obvious ways, like after handling raw meats that have invisible amounts of animal poop on them. A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs. Germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it or was touched by some other contaminated object. When these germs get onto hands and are not washed off, they can be passed from person to person and make people sick.

Washing hands prevents illnesses and spread of infections to others

Handwashing with soap removes germs from hands. This helps prevent infections because:

• People frequently touch their eyes, nose, and mouth without even realizing it. Germs can get into the body through the eyes, nose and mouth and make us sick.
• Germs from unwashed hands can get into foods and drinks while people prepare or consume them. Germs can multiply in some types of foods or drinks, under certain conditions, and make people sick.
• Germs from unwashed hands can be transferred to other objects, like handrails, table tops, or toys, and then transferred to another person’s hands.
• Removing germs through handwashing therefore helps prevent diarrhea and respiratory infections and may even help prevent skin and eye infections.

Teaching people about handwashing helps them and their communities stay healthy. Handwashing education in the community:

• Reduces the number of people who get sick with diarrhea by 23-40%
• Reduces diarrheal illness in people with weakened immune systems by 58%
• Reduces respiratory illnesses, like colds, in the general population by 16-21%
• Reduces absenteeism due to gastrointestinal illness in schoolchildren by 29-57%

Not washing hands harms children around the world

About 1.8 million children under the age of 5 die each year from diarrheal diseases and pneumonia, the top two killers of young children around the
world.

• Handwashing with soap could protect about 1 out of every 3 young children who get sick with diarrhea and almost 1 out of 5 young children with respiratory infections like pneumonia.
• Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more effectively.
• Handwashing education and access to soap in schools can help improve attendance.
• Good handwashing early in life may help improve child development in some settings.
• Estimated global rates of handwashing after using the toilet are only 19%.

Handwashing helps battle the rise in antibiotic resistance

Preventing sickness reduces the amount of antibiotics people use and the likelihood that antibiotic resistance will develop. Handwashing can prevent about 30% of diarrhea-related sicknesses and about 20% of respiratory infections (e.g., colds). Antibiotics often are prescribed unnecessarily for these health issues. Reducing the number of these infections by washing hands frequently helps prevent the overuse of antibiotics—the single most important factor leading to antibiotic resistance around the world. Handwashing can also prevent people from getting sick with germs that are already resistant to antibiotics and that can be difficult to treat.

Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. CDC recommends cleaning hands in a specific way to avoid getting sick and spreading germs to others. The guidance for effective handwashing and use of hand sanitizer was developed based on data from a number of studies.

Microbes are all tiny living organisms that may or may not cause disease.

Germs, or pathogens, are types of microbes that can cause disease.

Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

Why? Because hands could become recontaminated if placed in a basin of standing water that has been contaminated through previous use, clean running water should be used. However, washing with non-potable water when necessary may still improve health. The temperature of the water does not appear to affect microbe removal; however, warmer water may cause more skin irritation and is more environmentally costly.

Turning off the faucet after wetting hands saves water, and there are few data to prove whether significant numbers of germs are transferred between hands and the faucet.

Using soap to wash hands is more effective than using water alone because the surfactants in soap lift soil and microbes from skin, and people tend to scrub hands more thoroughly when using soap, which further removes germs.

To date, studies have shown that there is no added health benefit for consumers (this does not include professionals in the healthcare setting) using soaps containing antibacterial ingredients compared with using plain soap. As a result, FDA issued a final rule in September 2016 that 19 ingredients in common “antibacterial” soaps, including triclosan, were no more effective than non-antibacterial soap and water and thus these products are no longer able to be marketed to the general public. This rule does not affect hand sanitizers, wipes, or antibacterial products used in healthcare settings.

Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.

Why? Lathering and scrubbing hands creates friction, which helps lift dirt, grease, and microbes from skin. Microbes are present on all surfaces of the hand, often in particularly high concentration under the nails, so the entire hand should be scrubbed.

Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.

Why? Determining the optimal length of time for handwashing is difficult because few studies about the health impacts of altering handwashing times have been done. Of those that exist, nearly all have measured reductions in overall numbers of microbes, only a small proportion of which can cause illness, and have not measured impacts on health. Solely reducing numbers of microbes on hands is not necessarily linked to better health. The optimal length of time for handwashing is also likely to depend on many factors, including the type and amount of soil on the hands and the setting of the person washing hands. For example, surgeons are likely to come into contact with disease-causing germs and risk spreading serious infections to vulnerable patients, so they may need to wash hands longer than a woman before she prepares her own lunch at home. Nonetheless, evidence suggests that washing hands for about 15-30 seconds removes more germs from hands than washing for shorter periods.

Rinse your hands well under clean, running water.

Why? Soap and friction help lift dirt, grease, and microbes—including disease-causing germs—from skin so they can then be rinsed off of hands. Rinsing the soap away also minimizes skin irritation. Because hands could become recontaminated if rinsed in a basin of standing water that has been contaminated through previous use, clean running water should be used.While some recommendations include using a paper towel to turn off the faucet after hands have been rinsed, this practice leads to increased use of water and paper towels, and there are no studies to show that it improves health.

Dry your hands using a clean towel or air dry them.

Why? Germs can be transferred more easily to and from wet hands; therefore, hands should be dried after washing. However, the best way to dry hands remains unclear because few studies about hand drying exist, and the results of these studies conflict. Additionally, most of these studies compare overall concentrations of microbes, not just disease-causing germs, on hands following different hand-drying methods. It has not been shown that removing microbes from hands is linked to better health . Nonetheless, studies suggest that using a clean towel or air drying hands are best.

Appropriate hand hygiene includes diligently cleaning and trimming fingernails, which may harbor dirt and germs and can contribute to the spread of some infections, such as pinworms. Fingernails should be kept short, and the undersides should be cleaned frequently with soap and water. Because of their length, longer fingernails can harbor more dirt and bacteria than short nails, thus potentially contributing to the spread of infection.

Before clipping or grooming nails, all equipment (for example, nail clippers and files) should be properly cleaned. Sterilizing equipment before use is especially important when nail tools are shared among a number of people, as is common in commercial nail salons.

Infections of the fingernails or toenails are often characterized by swelling of the surrounding skin, pain in the surrounding area, or thickening of the nail. In some cases, these infections may be serious and need to be treated by a physician.

To help prevent the spread of germs and nail infections:

• Keep nails short and trim them often.
• Scrub the underside of nails with soap and water (or a nail brush) every time you wash your hands.
• Clean any nail grooming tools before use.
• In commercial settings such as nail salons, sterilize nail grooming tools before use.
• Avoid biting or chewing nails.
• Avoid cutting cuticles, as they act as barriers to prevent infection.
• Never rip or bite a hangnail. Instead, clip it with a clean, sanitized nail trimmer.

Facial cleanliness is important to your health. Use soap and clean, running water to remove dirt, oil, and unwanted debris from your face.

Many diseases and conditions can be prevented or controlled through appropriate personal hygiene and by frequently washing parts of the face. Appropriate facial hygiene practices include not only washing the face but also properly caring for teeth, mouth, eyes, contact lenses, and ears.

Think Before Touching Your Face

Your hands can make your face dirty. Thinking before touching your face can help stop the spread of germs. On average, people touch their faces 23 times per hour.¹ Unwashed hands can easily spread germs to your face after touching contaminated surfaces or objects. Protect yourself by:

• Washing your hands at keys times (such as before touching your face or putting in contact lenses)
• Using a tissue for your nose
• Using a tissue to scratch or rub your eyes or to adjust your glasses
• Preventing itchiness by using facial moisturizer for dry skin and eye drops for dry eyes

Keep Your Face Mask Clean

Wearing a mask that covers your mouth and nose can be an important way to prevent the spread of respiratory illness. Keeping your mask clean will help keep your skin healthy. Wash reusable masks before wearing them and as soon as they become dirty. If you use a disposable face mask, throw it away after wearing it once.

Face Washing Is Key in Preventing Spread of Some Diseases

Respiratory illnesses can be caused by many different bacteria and viruses. Typically, respiratory infections, like the common cold, flu, and COVID-19, can spread through droplets in the air when an infected person coughs or sneezes. They can also be spread by direct contact with bacteria, viruses, and other disease-causing germs. When you touch your face, the germs on your hands can enter your mucous membranes through your nose, eyes, and mouth, causing infection. Protect yourself by washing your hands before touching your face.

Pink eye (conjunctivitis) spreads easily from person to person. Good hygiene practices, such as handwashing, face washing, and not touching or rubbing eyes, are important for limiting the spread of pink eye.

Trachoma is rare in the United States, but it is the world’s leading cause of preventable blindness. It spreads through close personal contact. It often infects entire families and communities. Poor facial hygiene can lead to the spread of this disease through eye-seeking flies and contaminated fingers. The promotion of good hygiene practices, such as handwashing and face washing at least once a day with water, is a key step in breaking the cycle of trachoma transmission.

Covering coughs and sneezes and keeping hands clean can help prevent the spread of serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and COVID-19. Germs can be easily spread by:

• Coughing, sneezing, or talking
• Touching your face with unwashed hands after touching contaminated surfaces or objects
• Touching surfaces or objects that may be frequently touched by other people

To help stop the spread of germs:

• Cover your mouth and nose with a tissue when you cough or sneeze
• Throw used tissues in the trash
• If you don’t have a tissue, cough or sneeze into your elbow, not your hands

Remember to immediately wash your hands after blowing your nose, coughing or sneezing.

Washing your hands is one of the most effective ways to prevent yourself and your loved ones from getting sick, especially at key times when you are likely to get and spread germs.

Covering coughs and sneezes and washing hands are especially important for infection control measures in healthcare settings, such as emergency departments, doctor’s offices, and clinics.

• Wash your hands with soap and water for at least 20 seconds
• If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands

To help prevent the spread of respiratory disease, you can also avoid close contact with people who are sick. If you are ill, you should try to distance yourself from others so you do not spread your germs. Distancing includes staying home from work or school when possible.

Many diseases and foot problems can be prevented through healthy personal hygiene and taking care of your feet. Healthy foot hygiene practices include not only washing your feet but also clipping your toenails and wearing well-fitting, protective footwear.

Basic Care for Healthy Feet

How to protect your feet:

• Wash your feet every day and dry them completely.
• Clip your toenails short and keep them clean.
• Change your socks at least once a day.
• Check your feet regularly for cuts, sores, swelling, dryness, and infected toenails and apply treatment as needed.
• When visiting a salon for foot care, choose a salon that is clean and licensed by your state’s cosmetology board. Make sure the salon sterilizes instruments after each use (such as nail clippers, scissors, and other tools).

Foot Hygiene Is Key in Promoting Good Health

Several foot-related conditions are directly related to hygiene:

Athlete’s foot, or tinea pedis, is an infection of the skin and feet that can be caused by a variety of fungi that thrive in warm, dark, and moist environments. Although tinea pedis can affect any part of the foot, the infection most often affects the space between the toes. Good hygiene practices, like keeping your feet and toes clean and dry and changing your shoes and socks regularly, help to prevent or control tinea pedis.

Diabetes can damage the nerves and affect blood flow in feet and legs. Poor foot hygiene can put you at an increased risk for infection.

Fungal nail infections are common infections of the fingernails or toenails that can cause the nail to become discolored, thick, and more likely to crack and break. Small cracks in your nail or the surrounding skin can allow these germs to enter your nail and cause an infection.

Hookworm is a parasitic worm (also called a helminth). Globally, it is one of the most common roundworms found in humans. Hookworm infection is most common in resource-limited settings with poor access to water, sanitation, and hygiene. The best way to avoid hookworm infection is not to walk barefoot in areas where hookworm is common and where the soil may be contaminated by human poop (feces).

Fish Pedicures and Fish Spas

During a fish pedicure, also known as a fish spa treatment, customers place their feet in a tub of water filled with small fish called Garra rufa. Garra rufa are sometimes referred to as “doctor fish” because they eat away dead skin found on people’s feet, leaving newer skin exposed.

Garra rufa are native to the Middle East, where they have been used as a medical treatment for people with skin diseases, like psoriasis.

Several published case reports describe illnesses resulting from fish pedicures.

Why have some states banned the use of fish pedicures?

Each state has the authority to ban fish pedicures, and some states have done that.

Reasons for the bans include the following:

• The fish pedicure tubs cannot be sufficiently cleaned between customers when the fish are present.
• The fish themselves cannot be disinfected or sanitized between customers, and there is no effective way to disinfect the tubs. Because of the cost of the fish, salon owners are likely to use the same fish multiple times with different customers, which increases the risk of spreading infections.
• Chinese Chinchin, another species of fish that is often mislabeled as Garra rufa and used in fish pedicures, grows teeth and can draw blood, increasing the risk of infection.
• Fish pedicures do not meet the legal definition of a pedicure.
• Some state regulations specify that fish at a salon must be contained in an aquarium.
• The fish must be starved to get them to eat skin, which might be considered animal cruelty.
• According to the U.S. Fish and Wildlife Service, Garra rufa could pose a threat to native plant and animal life if released into the wild because the fish is not native to the United States.

Maintaining a healthy scalp and hair through good hygiene and proper hair care can help prevent and control many diseases and conditions. Use soap and clean, running water to remove dirt, oil, and unwanted residue from your head.

Break up the Buildup

Like the rest of your skin, the scalp produces a natural oil called sebum that moisturizes and protects your skin from infection. Some people produce more sebum than others. When the body produces too much sebum, it can build up on your scalp. If you shower less frequently, dead skin, dirt, product residue, and sweat may also build up on your scalp. This can result in greasy hair, increased risk for infection, and unpleasant odor. Practice these habits to improve your scalp and hair care routine:

• Use an exfoliator on the scalp to break up the buildup
• Select a shampoo and conditioner that work for your hair type
• Wash your hair regularly
• Brush regularly to prevent tangled hair and to help break apart buildup

Washing Your Scalp Helps Control Scalp Conditions and Infections

Ringworm on the scalp spreads through direct contact with an infected animal or person, or from the environment. Good hygiene practices, like not sharing combs, towels, or other personal items and washing your hands regularly, can help protect you.

Head lice spread most commonly by direct head-to-head (hair-to-hair) contact. However, much less frequently, they can spread through shared clothing or other belongings. This can happen if lice crawl onto those items or eggs attached to shed hairs fall on the items. Good hygiene practices are important for preventing and controlling the spread of head lice. For example, don’t share combs, brushes, or towels. Machine wash clothes and linens used by people with head lice.

Menstruation (also called your “period”) is a normal biological process experienced by millions around the world each month. Your period happens when your uterus sheds blood and tissue from the uterine lining and leaves your body through your vagina.

Practice Healthy Habits During Your Period

Good menstrual health and hygiene practices can prevent infections, reduce odors and help you stay comfortable during your period.

You can choose many types of menstrual products to absorb or collect blood during your period, including sanitary pads, tampons, menstrual cups, menstrual discs, and period underwear. Follow these tips when you are using menstrual products, in addition to instructions that come with the product:

• Wash your hands before and after using the restroom and before using a menstrual product.
• Discard used disposable menstrual products properly: wrap them with toilet paper, a tissue, or other material and then toss in a trash bin. Do not flush menstrual products down the toilet.
• Sanitary pads: Change sanitary pads every few hours, no matter how light the flow. Change them more frequently if your period is heavy.
• Tampons: Change tampons every 4 to 8 hours. Do not wear a single tampon for more than 8 hours at a time.
  • Use the lowest-absorbency tampon needed. If you can wear one tampon for up to 8 hours without changing, the absorbency may be too high.
• Menstrual cups: Clean cups every day after use. Sanitize menstrual cups after your period is over by rinsing them thoroughly and then placing them in boiling water for one to two minutes.
• Period underwear: Most reusable period underwear is machine washable. Follow product directions on the best way to clean.

Menstrual Hygiene Is Key in Promoting Good Health

These hygiene practices can help you stay healthy and comfortable during your period:

• Wear lightweight, breathable clothing (such as cotton underwear). Tight fabrics can trap moisture and heat, allowing germs to thrive.
• Change your menstrual products regularly. Trapped moisture provides a breeding ground for bacteria and fungi. Wearing a pad or period underwear for too long can lead to a rash or an infection.
• Keep your genital area clean. Wash the outside of your vagina and bottom every day. When you go to the bathroom, wipe from the front of your body toward the back, not the other way. Use only water to rinse your vulva. The vagina is a self-cleaning organ. Changing the natural pH balance of your vagina by washing or using chemicals to cleanse out the vagina can be harmful and may result in yeast infection or bacterial vaginosis.
• Use unscented toilet paper, tampons, or pads. Scented hygiene products can irritate the skin and impact your natural pH balance.
• Drink enough liquids. This can help wash out your urinary tract and help prevent infections, like vaginal candidiasis.
• Track and monitor your period. Your menstrual cycle is a valuable marker for your overall health. Irregular periods can be a sign of conditions like diabetes, thyroid dysfunction, and celiac disease. You can track your period on a calendar or with an app on your phone designed for this purpose.
• Visit a healthcare provider for your annual check-up. An annual well-woman exam is a full check-up includes a pap smear, a pelvic exam, and a breast exam. These exams are essential for good reproductive health as they can catch early signs of cancer or other health issues.

Talk to a doctor if you experience a change in odor, have extreme or unusual pain, or have more severe period symptoms than usual (such as a heavier flow or longer period).

Dental hygiene refers to the practice of keeping the mouth, teeth, and gums clean and healthy to prevent disease. Dental hygiene and oral health are often taken for granted but are essential parts of our everyday lives.

Tooth Decay

Tooth decay (cavities) is a common problem for people of all ages. For children, untreated cavities can cause pain, absence from school, difficulty concentrating on learning, and poor appearance, all problems that greatly affect quality of life and ability to succeed. Children from lower income families often do not receive timely treatment for tooth decay and are more likely to suffer from these problems. Tooth decay also is a problem for many adults. Adults of some racial and ethnic groups experience more untreated decay.

Periodontal Disease

Periodontal (gum) disease is an infection caused by bacteria under the gum tissue that begin to destroy the gums and bone. Teeth become loose, chewing becomes difficult, and teeth may have to be extracted. Gum disease may also be related to damage elsewhere in the body; recent studies point to associations between oral infections and diabetes, heart disease, stroke, and preterm, low-weight births. Research is underway to further examine these connections.

Many children and adults still go without simple measures that have been proven effective in preventing oral diseases and reducing dental care costs. For example, fluoride prevents tooth decay, and the most cost-effective way to deliver the benefits of fluoride to all residents of a community is through water fluoridation; that is, adjusting the fluoride in the public water supply to the appropriate level for decay prevention. Dental sealants, plastic coatings applied to the chewing surfaces of the back teeth where most decay occurs, are another safe, effective way to prevent cavities. However, only about one-third of children aged 6–19 years have sealants. Although children from lower income families are almost twice as likely to have decay as those from higher income families, they are only half as likely to have sealants.

Here are some things you can do to ensure good oral health for your child:

• Encourage your children to eat regular nutritious meals and avoid frequent between-meal snacking.
• Protect your child’s teeth with fluoride.
  • Use a fluoride toothpaste. If your child is less than 7 years old, put only a pea-sized amount on their toothbrush. Seek advice from a dentist or other health care professional before introducing fluoride toothpaste to children under 2 years of age.
  • If your drinking water is not fluoridated, talk to a dentist or physician about the best way to protect your child’s teeth.
• Talk to your child’s dentist about dental sealants. They protect teeth from decay.
• Regularly floss teeth.

Proper tooth brushing is critically important to good dental hygiene. Parents can help their children practice proper tooth brushing by starting to clean teeth early, using the right amount of fluoride toothpaste, supervising tooth brushing, and talking to a pediatrician or dentist about a child’s specific fluoride needs.

Good personal hygiene and handwashing are critical to help prevent the spread of illness and disease. Sanitation and hygiene become especially important during an emergency, such as a natural disaster, when finding clean, safe water could be difficult.

Learn about important cleanliness tips to keep yourself and loved ones healthy during an emergency.

Wash your hands to prevent the spread of germs

Keep hands clean to help prevent the spread of germs. During a boil water advisory or do not drink water advisory, it may be safe to wash hands with tap water. If local authorities or your doctor recommend extra caution, wash your hands with soap and water that has been boiled or disinfected.

• Wash your hands with soap and water for at least 20 seconds, especially during key times when you are most likely to spread germs.
• If clean tap water is not available, create a temporary handwashing station by using a large water jug.
• If you do not have soap and water use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs and might not remove harmful chemicals. Hand sanitizers are not as effective when hands are visibly dirty or greasy.

Follow local guidance on water that is safe for bathing

If you are on municipal water, listen to your local health and drinking water authorities for guidance on whether you can bathe or shower after a water-related emergency. Sometimes water that is not safe to drink can be used for bathing, but be careful not to swallow any water or get it in your eyes.

Do not bathe:

• In water that may be contaminated with sewage or toxic chemicals.
• In rivers, streams, or lakes that are contaminated by flood water, human sewage, or animal waste.

If you have a drinking water well, listen to your local health authorities for advice on using well water for showering and bathing. If extensive flooding has occurred or you suspect your well may be contaminated, contact your local, state, or tribal health department for specific advice on well testing and disinfection.

Use only clean water to brush your teeth

Use only clean water to brush your teeth after a water-related emergency. Listen to local authorities to find out if tap water is safe to use.

Keep wounds clean and covered

Keeping wounds clean and covered is crucial during an emergency. Open wounds and rashes that have been exposed to contaminated water can become infected. Naturally occurring bacteria such as Vibrio that live in certain coastal waters can also cause a skin infection when an open wound is exposed to salt water or brackish water, a mix of salt and fresh water often found where rivers meet the sea.

To protect yourself and your family:

• Avoid contact with flood waters, salt water, or brackish water if you have an open wound (including cuts and scrapes).
• Keep open wounds as clean as possible by washing well with soap and clean water.
• Cover clean, open wounds with a waterproof bandage to reduce your chance of infection.
• Seek immediate medical care if a wound develops redness, swelling, or oozing.

Follow guidelines for safe diapering

It’s always important to change diapers in a safe, germ-free way, but an emergency can make this difficult. Even a microscopic amount of poop can contain millions of germs.