Background It is important to understand the interaction of various predictors with oral health-related quality of life (OHRQoL) to better design effective interventions to improve OHRQoL. Aim The aim of this study was to develop and validate a conceptual model evaluating the factors affecting the OHRQoL in children. Design The study group consisted of 754 parent-child dyads. The data collection tools were a socio-demographic data form, the Early Childhood Oral Health Impact Scale (ECOHIS), Corah Dental Anxiety Scale (C-DAS), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and an oral and dental health examination form. A conceptual model was developed to examine the factors affecting OHRQoL in children consisting of four endogenous and four exogenous variables. Path analysis was used to test the compatibility of the conceptual model. Results OHRQoL was associated with parental socio-economic status (beta = -0.12; P < .001), dental anxiety (beta = -0.15; P < .001), and oral health behaviours (beta = -0.13; P < .001). Although parental dental anxiety had the strongest direct effect on OHRQoL, children's oral health behaviours had the strongest indirect effect. Conclusions This study revealed a valid demonstrable path of association between parental socio-economic status, dental anxiety, childhood dental anxiety, oral health behaviours, and OHRQoL.