Abstract
OBJECTIVE: This study aimed to develop a conceptual model exploring the relationships between perceived social support (PSS), self-efficacy, racial discrimination, and oral health (OH) in adolescents. METHODS: A cross-sectional study of adolescents aged 12-18 was conducted at a university dental clinic. Participants completed a questionnaire on demographics, OH, PSS, general self-efficacy, and task-specific self-efficacy (TSSE). Structural Equation Modeling (SEM) was used for analysis. RESULTS: A total of 252 adolescents participated in the study, with an average age of 14 years; 60% were female, 81% were born in Canada, 56% identified as White, and 20% perceived discrimination. PSS was positively associated with general self-efficacy (p = 0.002), TSSE for dental visits (p = 0.004), dietary habits (p = 0.004), and tooth-brushing (p = 0.002), while also elevating sugar consumption (p = 0.002). PSS (p = 0.048) and discrimination (p = 0.01) reduced tooth-brushing frequency. Self-efficacy for dietary habits (p = 0.005) and tooth-brushing (p = 0.002) positively correlated with increased tooth-brushing, while self-efficacy for dietary habits decreased sugar consumption (p = 0.001). Self-efficacy for tooth-brushing was linked to reduced dental visits (p = 0.02). PSS indirectly increased brushing frequency (p = 0.02) and reduced dental-care utilization (p = 0.004). Discrimination indirectly reduced self-efficacy for dental visits (p = 0.003) but increased self-efficacies for tooth-brushing (p = 0.01) and dietary habits (p = 0.03). CONCLUSION: PSS was directly related to increased self-efficacy, while discrimination indirectly affected OH. Oral health was associated with self-efficacy for dietary habits and tooth-brushing, but not dental visits alone. IMPLICATIONS FOR HEALTH EQUITY: The findings underscore the critical need to address systemic inequities in oral health care access. By exploring the interplay between social support, discrimination, and self-efficacy, this study highlights actionable pathways to reduce disparities and improve oral health outcomes among adolescents.