A Question of Health: Tight pants still add up

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I HAVE recently started developing sore gums and the dentist has suggested that I use an antiseptic mouthwash. Is this any better than just brushing my teeth with fluoride toothpaste?

Gingivitis, or inflammation of the gums, usually results from bacteria in the mouth which form into plaque on the teeth. This plaque causes the gums to become inflamed and infected. Antiseptic mouthwashes are an effective way of reducing the bacteria in the mouth. The mouthwashes need to be used at least twice a day over a long period of time. Toothpaste has little effect on gingivitis.

CAN A man's fertility be affected by wearing tight underwear?

The testicles, where sperm are produced, normally hang down behind a man's penis. The temperature of the testicles is slightly lower than that of the rest of the body, and research has shown that raising the temperature of the testicles artificially (ouch!) interferes with sperm production. When a man has a fever, his production of sperm is also reduced. But enterprising medical researchers have studied tight cycling-shorts to see if they might be used as a contraceptive. They have found that, although tight underwear does slightly raise the temperature of the testicles, it does not have any significant effect on sperm numbers.

IS IT necessary to have a travel vaccination against hepatitis A if I have already caught hepatitis A on a previous trip abroad?

If you are certain that you had hepatitis A, it is unnecessary to be vaccinated against it. But the only way to be absolutely certain that you are already protected is to have a blood test. Ask for a test to see whether you have antibodies against the hepatitis A virus. If these antibodies are present, you should be fully protected against hepatitis A without any further vaccinations. But remember that there are other forms of hepatitis (B and C) which you can still catch, even if you are immune to hepatitis A. Hepatitis A is usually caught from eating or drinking contaminated food or water. Hepatitis B and C are transmitted by sexual contact, dirty needles and blood transfusions.

WHAT ARE the side-effects of ACE inhibitors?

ACE (angiotensin-converting enzymes) inhibitors are a family of drugs used to treat high blood pressure and heart failure. They all have names that end in "pril", such as captopril, ramipril, etc, and are remarkably free of side-effects with one surprising exception. Quite a few people who take ACE inhibitors develop an irritating dry cough. Because it is such an odd side-effect, patients often do not mention it. When the ACE inhibitors are stopped, the cough disappears almost immediately.

Write to: A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; e-mail health@independent.co.uk

Dr Kavalier cannot respond personally to questions