Dental caries is the single most common chronic disease affecting children in the USA. Approximately 20-25% children are affected. This not only has serious implications for a child's long term health and well being but also has serious financial implications. The American Academy of Pediatric Dentistry advocates early intervention with the first dental visit by 12 months of age. Objective: The aim of this study was to determine the first dental visit for children living in a socio economically deprived area in Connecticut. This study was conducted at a Federally Qualified Health Center in Connecticut. Study Design: Data was collected prospectively on the children between January to December 2004. Results: We found that the mean age for the first visit was 4 years. The recommendation is that community health programs should emphasize the importance of preventive dental care by assuring the first dental visit be by age 1 year.

Background There is insufficient evidence in children and adolescents living with HIV (CALHIV) to guide the timing of antiretroviral treatment (ART) initiation after starting treatment for pulmonary tuberculosis (pTB). To address this knowledge gap, we evaluated the risk of mortality associated with the timing of ART initiation in ART-naïve CALHIV treated for pTB. Methods Data was extracted from electronic medical records of ART-naïve patients, aged 0-19 years, who were treated for HIV-associated pTB at Baylor Centers of Excellence in Botswana, Eswatini, Malawi, Lesotho, Tanzania, or Uganda between 2013 and 2020. Data was analyzed against a primary outcome of all-cause mortality with unadjusted Kaplan-Meier curves as well as Cox proportional hazard models. Results The study population included 774 CALHIV with variable intervals to ART initiation after starting TB treatment: under two-weeks (n = 266), two-weeks to two-months (n = 398), over two-months (n = 66) and no ART initiated (n = 44). Adjusted Cox proportional hazard models demonstrated increased mortality one year from TB treatment initiation in children never starting ART (aHR 2.67; 95% CI 1.03, 6.94) compared to children initiating ART between two-weeks and two-months from TB treatment initiation. Mortality risk did not differ for the under two-weeks group (aHR 1.02; 95% CI 0.55, 1.89) compared with the group initiating ART between two-weeks and two-months. Conclusions This retrospective study demonstrated no increase in mortality among CALHIV initiating ART less than two-weeks from TB treatment initiation. Given the broad health benefits of ART, this evidence supports the recent WHO recommendation for CALHIV to initiate ART within two-weeks of initiating TB treatment.