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Background: Based on Basic Health Research in 2018, the proper brushing teeth behavior in children in Indonesia was 2.8%. The Elementary School period is an important stage for develop­ing the behavior of maintaining den­tal and oral health in children (students). This stu­dy aim­ed to analyze the bio psychosocial de­ter­­­mi­­nants of the behavior of maintaining den­tal and oral health in elementary school children in Ponorogo by implementing the theory of Health Belief Model. Subjects and Method: This was a cross-sec­tio­nal study conducted in Pono­rogo, East Java, Indonesia, from January to Feb­­ruary 2020. A sample of 200 students from 25 elementary schools was selected by simple random sampling. The dependent vari­able was dental and oral health behavior. The independent variables were know­­­ledge, teacher’s role, attitude, perceived sus­cep­tibility, perceived seriousness, perceived be­ne­fit, perceived barrier, cues to action, self-effi­cacy, and school. The data were co­ll­e­c­t­­ed by questionnaire. The data were analyz­ed by a multilevel multiple logistic regression run on Stata 13. Results: Dental and oral health behavior in elementary school students in­creas­ed with good knowledge (OR= 8.73; 95% CI­= ­­2.18 to 34.95; p= 0.002), strong teacher’s role (OR= 3.99; 95% CI= 1.17 to 13.65; p= 0.027), posi­tive attitude (OR= 6.45; 95% CI= 1.73 to 24.04; p=­ 0.­005), strong perceived susceptibility (OR= 7.81; 95% CI= 2.12 to 28.78; p= 0.011), high perceived seri­ousness (OR= 6.62; 95% CI= 1.93 to 22.69; p= 0.003), weak perceived barrier (OR= 0.18; 95%­ CI= 0.05 to 0.72; p = 0.015), big perceived be­nefit (OR= 7.78; 95% CI= 1.80 to 33.56; p= 0.­006), strong cues to action (OR= 3.95; 95% CI= 1.12 to 13.91; p= 0.032), and strong self-efficacy (OR­=­ 4.­99; 95% CI= 1.38 to 18.05; p=0.014 ). Elementary schools had contextual effect on the dental and oral health be­ha­vi­or with ICC= 14.14%. Conclusion: The behavior of maintaining den­tal and oral health in elementary school students is affected by good knowledge, strong teacher’s role, high perceived susceptibility, high perceived serious­ness, weak perceived barrier, big per­ceiv­ed benefit, high cues to action, and strong self-effi­cacy. The school has a contextual effect on the be­haviour of maintaining dental and oral health in students. Keywords: the behaviour of maintaining dental health, health belief model.

journal of health promotion and behavior

Biopsychosocial Determinants of Dental and Oral Health Behavior in Elementary School Children in Ponorogo, Indonesia: Application of Health Belief Model