Maternal periodontitis and orofacial clefts: Evidence and treatment

Severe periodontitis lesions can harbor hundreds of thousands of copies of productive cytomegalovirus. Cytomegalovirus virions from maternal periodontitis can enter the bloodstream and potentially infect a fetus, leading to serious congenital disorders or diseases. Cleft lip and palate have been associated with congenital cytomegalovirus infections. A review of the literature suggests that babies are at increased risk for developing orofacial clefts if born to a woman with severe periodontitis, a weakened immune system, and an active cytomegalovirus infection during the first trimester of pregnancy. The proposed periodontal treatment aims to eliminate cytomegalovirus from the periodontium, thereby reducing the risk of orofacial clefts. The treatment involves 1 week of systemic valacyclovir and daily sodium hypochlorite oral rinsing during the 2 months before conception and the first trimester of pregnancy. In summary, cytomegalovirus in maternal periodontitis is a risk factor for the development of orofacial clefts in an unborn baby, who may benefit from preemptive periodontal treatment. Women should be informed that untreated maternal periodontitis can lead to serious birth defects in the mouth and throughout the body.