Dr. Kim’s Blog
Welcome to my blog! This blog is a product of my love of dentistry. I dedicate it to all the patients I have served so that they may better understand my craft. The information here will give you and others the power to maintain and protect one of your most priceless gifts ... your SMILE. Happy reading!
Our Seattle Dentist and TMJ Treatment - Part 2
Freedom from TMJ Pain with our Seattle Dentist
Last week, we discussed the ravaging effects of TMJ disorders on your jaw and your life. This week, we’re talking about ways to find relief from TMJ-related pain and frustration. Our North Seattle dentist offers a number of treatments to alleviate your TMJ discomfort and help improve your jaw’s function. Additionally, there are exercises and you can engage in at home to help retrain your TMJ to move in healthy ways. Our staff cares about your comfort, and will work alongside you until you are able to enjoy your daily activities once more, free of jaw pain and jaw restriction.
Our North Seattle Dentist Alleviates your Jaw Pain with TMJ Treatments
Dr. Okamura is an expert in facial musculature and will be able to diagnose and treat your TMJ with ease. We offer a variety of TMJ therapies to accommodate your needs and the level of joint dysfunction.
- Botox Therapeutic – Botox works by blocking muscle nerve receptors from receiving commands to contract. This is most commonly used to calm forehead muscles and thereby soften facial lines. But Botox is also incredibly useful in pain-relieving applications. When a TMJ refuses to relax, it is difficult to persuade the jaw joint to cooperate and the pain can be overwhelming. Botox forces the TMJ to cease contracting, and allows your jaw respite from overwork. Botox trigger point therapy doesn’t prevent you from using your jaw; it simply minimizes the harmful effects of a TMJ disorder. Our specially trained North Seattle dentist and staff have used this therapy to great effect.
- TMJ Massage Therapy – Pointed massage of the TMJ can help it regain normal function and eliminate accompanying pain.
- TMJ Splints – A TMJ disorder often flares up at night, when you have little control over your muscle movements. A TMJ splint will restrict your jaw from moving in harmful ways and help it behave while you are unconscious. This leads to less aggravation of the TMJ and allows for deeper sleep.
Personal TMJ Exercises to Relax Your Jaw | Our Seattle Dentist
In addition to the treatment you receive in our office, there are a few simple exercises you can practice at home to relieve the symptoms of a TMJ disorder.
- A focus on relaxation – Throughout your day, make a conscious effort to allow your jaw to relax. Try to pay attention to your jaw and unclench it regularly. Attention to relaxation will pay off with a less active TMJ.
- Healthy movements – Don’t chew gum for long amounts of time, eat very hard foods, or rest your chin on your hand. All these movements and the pressure involved can stress the TMJ.
- Hot or cold compresses – Ask your North Seattle dentist for a compress regimen that will relieve immediate TMJ pain.
While personal TMJ exercises can help lessen your pain, only a dentist can access the root of the problem and help prevent it from returning. If you’re fed up with jaw pain and ready to seek professional treatment, don’t hesitate to contact our office. Dr. Okamura and our team have brought freedom from TMJ pain to countless patients, and are ready to soothe your jaw and your life.
Our Seattle Dentist Offers TMJ Treatment
Experience Relief from Jaw Pain with our North Seattle Dentist and Soothing TMJ Treatment

Place your fingers directly in front of your ears and open your mouth, then move your lower jaw from side to side. You’ll be able to feel the hardworking connector between your upper and lower jaws, the temporomandibular joint (TMJ). This joint accomplishes myriad tasks and is responsible for much of your ability to chew, speak, and physically express yourself. Unfortunately, this joint can fall prey to a number of disorders, causing pain and reducing ease of use.
Our North Seattle dentist and staff are specially trained in TMJ therapy and offer a number of solutions for your jaw pain. Whether through massage therapy or muscle-relaxing Botox, we will find a way to bring you relief. This topic is so important to us and therapy has brought such relief to our patients that we’re doing a two-part blog post. Learn about TMJ disorders this week, then check back with us next Tuesday to discover how Dr. Okamura and our team can treat your TMD.
North Seattle Dentist on Causes of TMJ and Chronic Facial Pain or Jaw Pain
Chronic pain can often be mysterious in origin. TMJ disorders may arise from a malfunctioning disc between the lower jaw (mandible) and the temporal bone (a part of the skull). But there may also be a number of other causes, stemming from your habits, lifestyle, or other issues. These include:
- Chronic teeth grinding (bruxism)
- Arthritis
- Malocclusion (a bad bite)
- Overuse of the jaw
- Trauma to the TMJ
Although the most significant symptom of a TMJ disorder is jaw pain or facial pain, that can result from many sources. What dictates that your pain is due to a TMJ disorder? You should contact our Seattle dentist if you experience pain accompanied by any of the following:
- Stiffness of the jaw
- Difficulty using the jaw while chewing, speaking, or opening the mouth
- Locking of the jaw
- Strange noises of any kind that accompany jaw movement
- A change in your bite / the way your teeth fit together.
These issues will affect your life and take a toll on your daily activities. Spending any amount of time dealing with chronic pain is draining, exhausting, and frustrating. Our North Seattle dentist can help you! Contact our office to learn more, and check back next week for our blog post on TMJ treatment.
Cold and Flu Season
The cold and flu season is upon us!!! I have noticed an uptick in the number of patients having irritated throats, a bit more sniffling and congestion. Other health care providers in our practice have also shared that they are seeing the effects of cold and flu about this time of the year. Check out this link, it shows a visual of where the cold and flu is more prevalent.
http://symptoms.webmd.com/cold-and-flu-map-tool/default.htm
Oh....and one other simple item that may help keep the sniffles away: purchase a separate travel size tube of toothpaste to be used by the ill person. This will prevent spreading germs to other toothbrushes, and always discard your toothbrush once your health returns so that those nasty little bugs don’t keep wreaking havoc!
Continual good health to each of you
Kim Okamura DDS
Don't Brush Where You Flush
Do you know what's lurking on your toothbrush?
Your toothbrush is loaded with germs, say researchers at England's University of Manchester. They've found that one uncovered toothbrush can harbor more than 100 million bacteria, including E. coli bacteria, which can cause diarrhea, and staphylococci ("staph") bacteria that cause skin infections.
But don't panic. Your mouth wasn't exactly sterile to begin with.
"The bottom line is, there are hundreds of microorganisms in our mouths every day," says Gayle McCombs, RDH, MS, associate professor and director of the Dental Hygiene Research Center at Old Dominion University. That's no big deal. Problems only start when there is an unhealthy balance of bacteria in the mouth.
It's important to remember that plaque -- the stuff you're removing from your teeth -- is bacteria. Fortunately, the human body is usually able to defend itself from bacteria.
So we aren't aware of any real evidence that sitting the toothbrush in your bathroom in the toothbrush holder is causing any real damage or harm. Still, you should exercise some common sense about storing your toothbrush, including how close it is to the toilet.
Most bathrooms are small. And in many homes, the toilet is pretty close to the bathroom sink where you keep your toothbrush. Every toilet flush sends a spray of bacteria into the air. And you don't want the toilet spray anywhere near your open toothbrush. "You don't store your plates and glasses by the toilet, so why would you want to place your toothbrush there?" “It's just common sense to store your toothbrush as far away from the toilet as possible." You also wouldn't eat after going to the bathroom without first washing your hands. The same advice applies before brushing your teeth.
Once you've moved your toothbrush away from the toilet, here are a few other storage tips to keep your brush as germ-free as possible:

1) Keep it rinsed. Wash off your toothbrush thoroughly with tap water every time you use it.
2) Keep it dry. "Bacteria love a moist environment.” Make sure your brush has a chance to dry thoroughly between brushings. Avoid using toothbrush covers, which can create a moist enclosed breeding ground for bacteria.
3) Keep it upright. Store your toothbrush upright in a holder, rather than lying it down.
4) Keep it to yourself. No matter how close you are to your sister, brother, spouse, or roommate, don't ever use their toothbrush. Don't even store your toothbrush side-by-side in the same cup with other people's brushes. Whenever toothbrushes touch, they can swap germs.
Small fruit, big benefits!
Everyone knows The Cranberries, yet how much do you know the cranberry? Cranberries are characterized by their distinct sweet taste and voluptuous red color, a native in many regions of the United States and other parts of the world. But what some people don't know about the cranberry is that it's a small fruit with big benefits.
Cranberries are a gift from nature. And like all of nature's gifts, it is very good for the human body. Some US states and other countries market cranberry as one of the few superfruits (a fruit with numerous health benefits) in the world—mainly Canada and the US states of New Jersey, Washington, Massachusetts, and Wisconsin.
Let's find out how cranberry juice helps you lead a better life.
• Rich in phytochemicals – You probably heard the term on TV, but what does it do exactly? Phytochemicals do a lot of good stuff for the body. Cranberry juice is a good source of polyphenol antioxidants and phytochemicals, both of which are possible deterrents against cancer and disorders of the cardiovascular and immune systems. That's a lot of benefits coming from a small fruit.
• Prevents urinary tract infection – Preservatives in food and beverages, along with poor hygiene, contribute to the rise in UTI cases these days. Cleanse by drinking a glass of unsweetened cranberry juice. Cranberry's anti-adhesion properties—or the proanthocyanidins minerals found in the fruit—help rinse the body of urinary tract infections caused by E. coli bacteria.
• Reduces dental plaque – Unless you're drinking sweetened cranberry juice, this beverage has nothing but good news for the teeth and gums. Experts say cranberry juice inhibit the growth of mouth bacteria that causes plaque. So drink up. A healthy dose of cranberry juice ensures your teeth are fresh and clean all the time.
• Prevents formation of kidney stones – This is still under active medical research, but the presence of quinic acid have experts saying it is possible for cranberry juice to help prevent the development of kidney stones. It makes sense since cranberry rid the body of wastes and bacteria—anything that doesn't belong there.
Don't keep out of reach of children
Cranberry juice is sweet and all natural, and it makes for a perfect treat for children. You'd have a hard time thinking of a better beverage to serve on the table during meals and snacks.
Of course all those benefits require that you drink an ample amount of cranberry juice everyday. A couple of 500ml (or 16-ounce) glasses of unsweetened cranberry juice ought to be enough to bring those benefits into effect. But if you aren't a juice type of person then consider taking capsules or syrup with cranberry juice extracts. Take one 400mg capsule twice a day, or one teaspoon three times a day, for optimum nourishment. You'll find yourself feeling fresh and rejuvenated in no time at all.
As with most manufactured fruit juices, cranberry juice comes in two varieties: sweetened and unsweetened. We advise anyone conscious about their health to go for the all natural unsweetened variety. So okay. It might not be as sweet in taste, but it's got sweeter benefits, that's for sure.
The cranberry isn't called superfruit for nothing—there must be something about it that makes it one of the most widely-harvested fruit crop in the US. So if you have never tasted cranberry your whole life, isn't it reason enough to give cranberry juice a try?
Botox at Your next Dental Appointment
As dentists, we are very familiar with two things: the function of each muscle in the face and giving intra-oral injections. Having the ability to deliver dermal fillers and Botox in a completely painless manner is one of the biggest advantages of getting these procedures done in the dental office. Most patients who have experienced fillers delivered with just topical skin anesthetics say that the level of pain does not warrant the results and would not go through the experience again.
Dermal fillers provide an appearance of fullness at the injection site adding volume to where the body’s natural collagen has been lost, due to the aging process. The most commonly used areas for fillers are, the smile lines (parentheses, deeper folds) marionette lines (corners of the mouth) and lip augmentation. The results are visible immediately and last for up to six months.
Botox was introduced about 20 years ago to reduce frown lines between the eyes, but today the cosmetic application has multiple advantages. Although the most common areas treated are the forehead, between the eyes, corners of the eyes and occasionally the corners of the mouth, Botox can also reduce pain and enhance a patient’s smile. Botox blocks the release of neurotransmitters on the motor nerves that govern movement and prevent them from contracting. Therefore, it can be used as a muscle relaxer to reduce chronic facial pain, teeth grinding and as an alternative to surgical treatment of “gummy smiles” (when the patient raises the upper lip too high while smiling, so pink gum tissue shows). Dentists have been using Botox to treat dental problems like temporomandibular joint (TMJ) disorders and the U.S. Food and Drug Administration approved its use for treatment of chronic migraines in 2008.
Some dentists want to take it a step further and use it for aesthetic purposes, too. We are finding that are clients are very delighted with the natural looking out come that we are able to provide to them. Our office and team have been able to alleviate many pre-conceived notions that may give rise to fear with people that have not tried Botox, because they have been lead to believe that it is bad for you. When used correctly and completed by a trained injector, Botox can have a profound effect on pain management and improved self esteem!
SPOT Skin Cancer
In Dentistry we are trained to look for oral cancer. Checking your skin and knowing what normal is for you is also very important and something you can do in the privacy of your home.
Skin cancer is the most common cancer in the United States and finding spots that could be cancerous is as simple as looking at your skin. Now a new video, “Skin Self-Exam: How to Do,” from the American Academy of Dermatology demonstrates how to check your skin and what to look for.
“Checking your skin for skin cancer only requires your eyes and a mirror. Involving a partner adds another set of eyes, which is especially helpful when checking the back and other hard-to-see areas,” said Thomas E. Rohrer, MD, FAAD, a board-certified dermatologist in private practice in Chestnut Hill, Mass. “Examining your skin only takes a few minutes, but it could save your life.”
When examining the skin, look for the ABCDEs of Melanoma and make an appointment with a board-certified dermatologist if any moles exhibit these signs:
A – Asymmetry: One half of the spot is unlike the other half.
B – Border: The spot has an irregular, scalloped or poorly defined border.
C – Color: The spot has varying colors from one area to the next, such as shades of
tan, brown, or black, or with areas of white, red or blue.
D – Diameter: Melanomas are usually greater than 6mm, or about the size of a
pencil eraser when they are diagnosed, but they can be smaller.
E – Evolving: A mole or spot on your skin that looks different from the rest or is
changing in size, shape, or color.
To check your skin, looking at the front and back of your body. When examining your own skin, stand in front of a mirror. Examine your skin by following these steps:
1. Raise the arms and examine the right and left sides of the body.
2. Then bend your elbows and look carefully at your forearms, upper underarms
and palms.
3. Next, examine the back of your legs, spaces between your toes and your soles.
4. Then, examine those hard‐to see areas like your back, buttocks and the top of
your head. Use a mirror to inspect the back of your neck and scalp, parting your hair for a better view.
“Current estimates show one in five Americans will be diagnosed with skin cancer in their lifetime, so it’s important to be familiar with your skin, especially your moles,” said Dr. Rohrer. “Catching skin cancer early is key for successful treatment, so check your skin regularly and see a board-certified dermatologist if you spot anything suspicious.”
The American Academy of Dermatology’s Body Mole Map helps people keep a record of moles that are growing, bleeding, itching or changing. The Body Mole Map is a resource of the Academy’s SPOT Skin Cancer® public awareness initiative. Visitors to the program’s website – www.SpotSkinCancer.org – also can find stories of those affected by skin cancer and free downloadable materials to educate others in their community.
The “Skin Self-Exam: How to Do” video is posted to the Academy’s website and YouTube channel. This video is part of the Dermatology A to Z: Video Series, which offers videos that demonstrate tips people can use to properly care for their skin, hair and nails. A new video in the series will be posted to the Academy’s website and the YouTube channel each month.
Easing Dental Fear in Adults
If you fear going to the dentist, you are not alone. Between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear. Indeed, it is a universal phenomenon.
Dental phobia is a more serious condition than anxiety. It leaves people panic-stricken and terrified. People with dental phobia have an awareness that the fear is totally irrational, but are unable to do much about it. They exhibit classic avoidance behavior; that is, they will do everything possible to avoid going to the dentist. People with dental phobia usually go to the dentist only when forced to do so by extreme pain. Pathologic anxiety or phobia may require psychiatric consultation in some cases.
Other signs of dental phobia include:
- Trouble sleeping the night before the dental exam
- Feelings of nervousness that escalate while in the dental office waiting room
- Crying or feeling physically ill at the very thought of visiting the dentist
- Intense uneasiness at the thought of, or actually when, objects are placed in your mouth during the dental treatment or suddenly feeling like it is difficult to breathe
Fortunately, there are ways to get people with dental anxiety and dental phobia to the dentist.
What Causes Dental Phobia and Anxiety?
There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:
- Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental "pain and horror" stories told by others. Thanks to the many advances in dentistry made over the years, most of today's dental procedures are considerably less painful or even pain-free.
- Fear of injections or fear the injection won't work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn't yet taken effect or wasn't a large enough dose to eliminate any pain before the dental procedure begins.
- Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don't like the numbness or "fat lip" associated with local anesthetics.
- Feelings of helplessness and loss of control. It's common for people to feel these emotions considering the situation -- sitting in a dental chair with your mouth wide open, unable to see what's going on.
- Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors.
The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable. If your dentist doesn't take your fear seriously, find another dentist.
If lack of control is one of your main stressors, actively participating in a discussion with your dentist about your treatment can ease your tension. Ask your dentist to explain what's happening at every stage of the procedure. This way you can mentally prepare for what's to come. Another helpful strategy is to establish a signal -- such as raising your hand -- when you want the dentist to immediately stop. Use this signal whenever you are uncomfortable, need to rinse your mouth, or simply need to catch your breath.
For many people the dental office is not an easy place to come. We delight in providing a place where people feel that they are being heard. Through open lines of communication and listening to each person’s individual needs, their lives are transformed from avoiding the dentist, to enjoying the experience that we provide. We are proud to say that we have helped many of our fearful clients achieve a very comfortable dental home!
Laser Cavity Detection
One of the most common treatments we as dentists do for our patients is to identify and fill cavities. Since even the smallest amount of decay can threaten an entire tooth, finding and filling cavities is the key to preventing future problems. That's why dentists spend time taking yearly x-rays and completing a visual exam every time you have an annual check up. However, many people don't realize that these methods of decay detection are only 50% to 75% successful.
Here’s the problem: Cavities often hide inside and under the tiny crevices inside and under the chewing surfaces of your teeth and the probe head can’t penetrate these tiny, pin-size holes. For these reasons, a new FDA-Approved laser device was invented called the Diagnodent.
This laser scanner will often find cavities up to 5 or even 10 years before they would have otherwise been found. Using microdental techniques, the decay can then be removed, often without the need for getting numb when the cavities are tiny and very easy to fix. Early detection means less chance of cracked teeth, future crowns, root canals and other major treatment
RELATED VIDEO: Cavity Laser
Grapefruit and your Rx
Grapefruit juice can be part of a healthful diet—most of the time. It has vitamin C and potassium, substances your body needs to work properly.
But it isn’t good for you when it affects the way your medicines work. Grapefruit juice and fresh grapefruit can interfere with the action of some prescription drugs, as well as a few nonprescription drugs.
This interaction can be dangerous, says Shiew Mei Huang, Ph.D., acting director of the Food and Drug Administration’s Office of Clinical Pharmacology. With most drugs that interact with grapefruit juice, “the juice increases the absorption of the drug into the bloodstream,” she said. “When there is a higher concentration of a drug, you tend to have more adverse events.”
For example, if you drink a lot of grapefruit juice while taking certain statin drugs to lower cholesterol, too much of the drug may stay in your body, increasing your risk for liver damage and muscle breakdown that can lead to kidney failure.
Drinking grapefruit juice several hours before or several hours after you take your medicine may still be dangerous, said Dr. Huang, so it’s best to avoid or limit consuming grapefruit juice or fresh grapefruit when taking certain drugs.
Examples of some types of drugs that grapefruit juice can interact with are:
- some statin drugs to lower cholesterol, such as Zocor (simvastatin), Lipitor (atorvastatin) and Pravachol (pravastatin);
- some blood pressure-lowering drugs, such as Nifediac and Afeditab (both nifedipine);
- some organ transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine);
- some anti-anxiety drugs, such as BuSpar (buspirone);
- some anti-arrhythmia drugs, such as Cordarone and Nexterone (both amiodarone);
- some antihistamines, such as Allegra (fexofenadine).
Tips for avoiding drug/grapefruit juice interactions:
- Ask your pharmacist or other heath care professional if you can have fresh grapefruit or grapefruit juice while using your medication
- Read the medication guide or patient information sheet that comes with your prescription medicine to find out if it could interact with grapefruit juice
- Read the drug facts label on your nonprescription medicine, which will let you know if you shouldn't have grapefruit or other fruit juices with it
- If you must avoid grapefruit juice with your medicine, check the label of bottles of fruit juice or drinks flavored with fruit juice to make sure they don't contain grapefruit juice
- Seville oranges (often used to make orange marmalade) and tangelos (a cross between tangerines and grapefruit) affect the same enzyme as grapefruit juice, so avoid these fruits as well if your medicine interacts with grapefruit juice
Grapefruit juice does not affect all the drugs in the categories above. Ask your pharmacist or other health care professional to find out if your specific drug is affected.
The FDA has required some prescription drugs to carry labels that warn against consuming grapefruit juice or fresh grapefruit while using the drug, says Dr. Huang. And the agency’s current research into drug and grapefruit juice interaction may result in label changes for other drugs as well.
