Authors
                            
                                                            
                                                                            1
                                                                        Assistant Professor, Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.                                
                                                            
                                                                            2
                                                                        Professor, Department of General Education, College of Education and Languages, Lebanese French University, Erbil, Kurdistan, Iraq.                                
                                                            
                                                                            3
                                                                        Assistant Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.                                
                                                            
                                                                            4
                                                                        Assistant Professor, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.                                
                                                            
                                                                            5
                                                                        Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.                                
                                                            
                                                                            6
                                                                        Assistant Professor, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.                                
                                                            
                                                                            7
                                                                        Assistant Professor, Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.                                
                                                            
                                                                            8
                                                                        Professor, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.                                
                            
                                                                            
                        
                        
                            Abstract
                            Background: Fear of dental care prevents dental cleaning behavior and increases the prevalence of dental caries. This study was conducted to determine the effect of Trans-Theoretical Model constructs and fear of dental care on the dental cleaning behavior of students. 
 Materials and Methods: This cross-sectional study was carried out in Sanandaj city, Iran, in 2017. Using multi-stage sampling, 1,344 male and female students were included in the study. They completed a self-report questionnaire, including demographic information, Trans-Theoretical Model constructs and fear of dental care. Data were analyzed using SPSS software (version 22.0).
 Results: A total of 1,344 male and female students with a mean age of 15.22±2.64 years participated in the study; from the perspective of students, dental caries (88.4%) was the most frequent illness and tongue inflammation (0.6%) was the least frequent disease.Overall, 32.9% of the students used no tools for cleaning their teeth. Fear of dental care and perceived barriers were reduced significantly during the stages of dental cleaning behavior (p<0.05) and perceived self-efficacy and perceived benefits were significantly increased (p<0.001). The odds of dental cleaning behavior increased with self-efficacy (OR=1.34, 95%CI=1.22-1.48, p<0.05), and decreased with fear of dental care (OR=0.90, 95%CI=0.80-0.98, p<0.01).
 Conclusion: The findings showed dental cleaning behavior among students was at a low level and various factors such as perceived self-efficacy, benefits and barriers and fear of dental care influenced its performance. 
                        
                        
                        
                                                    Keywords