International Journal of Environmental Research and Public Health | An Interview with One of the Authors—Prof. Dr. Lívia Guimarães Zina

Name: Prof. Dr. Lívia Guimarães Zina
Affiliation: Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
Research interests: oral health care for pregnant women; breastfeeding; evidence-based dentistry; service evaluation

“Changes, Desire, Fear and Beliefs: Women’s Feelings and Perceptions About Dental Care During Pregnancy”
by Natália Correia Fonseca Castro, Vânia Maria Godoy Pimenta Barroso, Henrique Cerva Melo, Camilla Aparecida Silva de Oliveira Lima, Rafaela Silveira Pinto and Lívia Guimarães Zina
Int. J. Environ. Res. Public Health 2025, 22(8), 1211; https://doi.org/10.3390/ijerph22081211
Available online: https://www.mdpi.com/1660-4601/22/8/1211

The following is a short interview with Prof. Dr. Lívia Guimarães Zina:

1. Congratulations on your recent publication. So, could you just briefly introduce yourself as well as your current research focus?
My name is Lívia. I am dentist, professor at the School of Dentistry of the Federal University of Minas Gerais (UFMG) in Brazil. In addition to teaching and research activities at both undergraduate and graduate levels, I serve as the coordinator of the professional master’s program in public health dentistry at UFMG and of the extension project “Like Mother, Like Child – Oral Health Promotion for Pregnant Women”. I have a PhD in preventive and social dentistry, and my main areas of interest are: prenatal dental care, breastfeeding, evidence-based dentistry, and health service evaluation. I have been training dental health professionals for prenatal dental care for 20 years.
The focus of my research is to understand the oral health challenges pregnant women face during pregnancy, how prenatal dental care should be offered, the facilitators and barriers to care, and how public health services can be better organized to provide improved access for pregnant women.

2. What initially inspired you to get into that research field?
I have been dedicated to this research field for over 20 years. Maternal and childcare has always inspired me, and the specific dental needs of pregnant women, combined with the recurring difficulty that dental professionals face in providing effective care for this group, have motivated me to devote my research and academic work to this area. My studies have sought to understand the oral health problems women experience during pregnancy, how these problems affect their quality of life, the social inequities to which pregnant women are exposed, and, most importantly, how dental public health services can expand access and improve the quality of prenatal dental care.

3. Did you encounter any significant challenges while conducting this research? And if you did, how did you overcome them?
Yes, there are always challenges when conducting field research. For example, it is necessary to obtain authorization from municipal services to carry out the study. In our case, since we had a partnership with the Municipal Health Department, we did not face difficulties in getting these approvals. On the other hand, it was challenging to conduct the interviews during the routine care of pregnant women. What I found most difficult, however, was reaching the women who had not received any dental care. Some pregnant women prefer private clinics, while our study was carried out in the public health system. To reach them, we had to rely on the help of some professionals to identify these patients and search for them. That is why one of the strengths of our recently published study is precisely that it explores the barriers and facilitators to accessing public dental services, from the perspective of both women who did not seek care and those who did. We were able to talk with these women and gain a deeper understanding of the challenges they face. This study is part of a larger project that also involved health professionals engaged in prenatal dental care, such as dentists, physicians, and nurses. From this broader perspective, it was possible to better understand the interprofessional work of the health team and the factors influencing access to prenatal dental care.

4. What you say is your top advice for newly pregnant women concerned about dental issues?
First, pregnant women need to see the dentist. Pregnancy puts women at a temporary risk for oral health problems, which is very common during this phase. So, dental visits should be part of prenatal care. However, most women are afraid of going to the dentist.
And even many dentists are not well prepared to care for them, because they don’t always have the right information or were not trained in their graduation courses. They also feel uncertain. They don’t know which medicines are safe to prescribe for pregnant women, which dental procedures can be performed, or even the best position for the patient in the dental chair. There are many things they are unsure about. So, what often happens is that they just say: “No, come back after the baby is born.”
But when the baby is born, mothers are overwhelmed with changes in their lives. They can’t always find the time to go to the dentist. As a result, many women continue to suffer. Pain is very common, as well as gum bleeding and other oral health problems.
Another important point is that many people already have a fear of going to the dentist, so here we actually face two barriers: the general fear of dental visits and the fear associated with pregnancy. This creates a serious problem, and it’s not just in Brazil—it’s worldwide. That is why we need more studies, and my focus has been on how dental services can be better organized and what strategies can be adopted to make access easier.

5. So what research questions are you aiming to explore next in your research?
We have been studying the facilitators and barriers, and now we are trying to carry out some interventions in the public dental service here in Brazil. The goal is to create new strategies for organizing care in order to expand access for pregnant women. My focus now is on the interprofessional approach, because many of our previous studies have focused mainly on dentists. But we haven’t achieved better results — the problems remain the same. So, we need to focus on nurses, midwives, and physicians – the antenatal care providers. How can we engage with them? How can they help refer pregnant women to the dentist? This is especially important in Brazil, where we have a universal health system. All pregnant women can go to health units and receive treatment, but many still don’t. So, why don’t they go? Why isn’t the system working as well as it should? We have financial support and backing from the government, we also have national guidelines for prenatal dental care, but the challenges persist. Another area of my research is to understand how Indigenous pregnant women access (or fail to access) dental treatment.

6. What appealed to you about the journal that made you want to submit your paper? How was your experience submitting to IJERPH?
The journal was preparing a Special Issue (“Perceptions of Women, Child and Adolescents’ Oral Health”), which aligned perfectly with the research we were conducting. So, it was an excellent opportunity. In addition, IJERPH is an internationally recognized journal known for its quality and scientific impact. The experience of submitting the paper was very positive. The process was fast, transparent, and efficient. Since its publication, we have been contacted by readers, and the fact that the paper is in open access has contributed to a wider dissemination of our study.

We sincerely thank Prof. Dr. Lívia Guimarães Zina for taking the time to speak with us. Her perspectives in the field of prenatal dental care and public health have been highly enlightening and valuable. We wish her continued success and significant impact as she advances her important work in improving oral health access for pregnant women worldwide.