A Sociobiological Model of Early Childhood Caries: The Role of Allostatic Load

Abstract

Objective: Even though many factors have been linked to increased ECC risk, few studies have specifically presented this information as a single comprehensive model. The purpose of this paper is to review the scope and usefulness of the proposed conceptual model in guiding future research of ECC risk as it relates to allostatic load. Methods:The various social, behavioural, and biological risk factors that emerge from the cumulative effects of chronic stress, defined as allostatic load, are discussed separately before being incorporated into a single sociobiological model of ECC.Results: In addition to biological realities, children experience profound impacts from their environments and family circumstances. The risk of developing ECC is especially pronounced in socially disadvantaged contexts. This information, as it is presented in the proposed conceptual model, reveals unique allostatic factors that work to increase risk at the level of the individual child, family, community, and society. Giving clinicians an idea of these realities has the capacity to more effectively screen and risk stratify children on the basis of dental health in the hopes of ultimately increasing their overall health as well. Conclusion:The proposed model provides a conceptual framework that relates factors of allostatic load to increased ECC risk. It demonstrates that a population-based, interprofessional collaboration strategy is essential to delivering effective prevention and treatment modalities to at-risk children. Future research regarding translational strategies has the capacity to reduce the prevalence of the biological, developmental, and psychosocial risk factors and thus ECC as a whole.