Coast Dental Blog

Fast Facts – Aggressive Perio

Fast Facts: Perio Edition Episode 27
[Andrew Johnston, RDH]
Welcome back,  everyone. You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello and welcome to Fast Facts: Perio Edition. Oh, my gosh, you guys, we are back and this week we’re picking up the conversation we started last week about new concepts in periodontal diagnostics.
We looked at the 1999 AAP classification system, and well I think we can all agree that in 1999 things were a bit different, remember, everybody was wearing Tamagotchi’s and wearing jelly shoes and slap bracelets and scrunchies. Now we know better. So we’re going to do better. In 2017 published and integrated in 2018, the American Academy of  Periodontology in their World Federation reclassified the way that we look at perio, sort of.
And what I mean by that is, a lot of the classification systems that we used in 1999 are still integrated today in 2017 and 2018.  And the reason why is because there was a lot of validity to these classification systems and over the next several weeks we’ll be looking at a lot of those classification systems.
There were a few differences that did occur between 1999 and 2017. One of those is the obliteration of classification three or aggressive periodontitis. Now a lot of us remember that aggressive periodontitis was the transient term that we used for a patient that seemed to have rapid rate, early onset, progressive disease. We would look at the mandibular anterior’s or we would look at the first molars on an adult patient and oftentimes we would see rapid rate scooped out bone around those teeth. And we classify that as localized, aggressive perio. Or in some cases we could see a patient who maybe was younger, or we could compare radiographs from one year to just the next year. And we would observe that in that amount of time or just based on how youthful that patient was, that they had incredible amounts of bone loss despite their age or despite the short amount of time that had progressed from x ray to x ray.
And so we termed that patient as having aggressive perio. It was believed that this patient had high quantities of a bacteria called Aggregatibacter actinomycetemcomitans. And so because of that, we basically said, you’ve got aggressive perio. You have a very specific type of bacteria in your mouth.
Well, now we know better. The AAP published in 2018 that as of right now, there’s no evidence of specific pathophysiology, which is just a fancy term for we can’t really say patients that have this aggressive rapid rate onset of disease is a patient who has high quantities of a specific type of bacteria. We couldn’t differentiate cases between aggressive and chronic perio. And so because of that, the AAP stated there’s little consistent evidence that aggressive and chronic periodontitis are different diseases.
Stay tuned next week as we look at the final difference between 1999 and the 2017 AAP staging and grading opportunities. Have an awesome week, you guys.
This has been another episode of Fast Facts – Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts – Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at We’ll see you next week for another Fast Fact!

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