Coast Dental Blog

Fast Facts – Aggregatibacter Actinomycetemcomitans

Perio Edition Episode 8
[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]
Welcome back to another episode of Fast Facts: Perio Edition with Katrina Sanders.Today, we are going to be talking about an outlier. You see, in previous episodes, we looked at the green, yellow, orange and red complex bacteria, but there is one guy who, for whatever reason, is just considered an outlier and doesn’t necessarily fit in with the other complexities of these bacterium as they’ve been classified by Socransky, and that, my friends, is our good old friend, Aggregatibacter actinomycetemcomitans. Now this bacteria, lovingly termed AA, is classified almost as a pink complex bacteria because of the ways that it simply does not align with the other strikingly related measures of some of the other bacteria that we were looking at. Now Aggregatibacter actinomycetemcomitans is an interesting bug because this particular bacteria is also gram negative and is anaerobic. However, we have found this specific type of bacteria associated with endocarditis and we also believe that it may be a trigger for autoimmune diseases such as rheumatoid arthritis, but I think we all remember from dental hygiene school that Aggregatibacter actinomycetemcomitans AA was associated with aggressive periodontitis.
For a long time. It was believed that individuals who had rapid rate episodic diseases of the periodontium had higher levels of this type of a bacteria and so we actually had an entire classification system in 1999 that classified people with aggressive periodontitis, assuming that they had high levels of this type of bacteria.
However, in 2017, the American Academy of Periodontology came together and looked at the research, and although there were some pieces of evidence that did point to the fact that there was some plausibility that AA could be present in rapid rate episodic cases, we also saw that P. gingivalis showed up to the party and along with her, she brought her buddies Tannerella forsythia and Treponema denticola. And so the Academy could not say for certain that there was a specific pathophysiology, which is just a fancy term for saying this is a bacteria linked to this disease, associated with AA and aggressive perio.
So what do we know about AA? Currently this bacteria, we believe, is linked to other systemic diseases when it is able to create a systemic burden by entering the bloodstream and circulating through the body and more so, this particular bacteria, we have now agreed, is not specifically associated with rapid rate onset progression of periodontal disease, but rather a combination of bacteria in tandem with risk factors. This is where we’ve begun to adapt the grading aspect of the AAP staging and grading.
Thank you so much for joining me today for Fast Facts: Perio Edition with Katrina Sanders. Enjoy the rest of your week and I will see you at the same time, same place, right here for more Fast Facts.
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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