Purpose: To evaluate the factors associated with the perceptions of oral health-related quality of life (OHRQoL) in children and preadolescents. Materials and Methods: 167 students aged 8-14 years were recruited from the public schools of Piracicaba, Brazil. Participants were examined for caries, gingivitis, fluorosis, malocclusions and signs and symptoms of temporomandibular disorders (TMD). OHRQoL was measured using the Brazilian Portuguese version of the Child Perceptions Questionnaire (CPQ 8-10 and 11-14), where higher scores indicate worse OHRQoL. Symptoms of anxiety and depression were evaluated using self-applied questionnaires. Sociodemographic characteristics, dental history and oral hygiene habits were evaluated using a questionnaire. Bivariate and multivariate analyses were used to identify the variables associated with CPQ scores. Results: Higher CPQ 8-10 scores were associated with fluorosis, TMD and symptoms of anxiety and depression. Higher CPQ 11-14 scores were associated with females, TMD and symptoms of anxiety and depression. Younger children (OR = 0.32, p 0.05) with signs and symptoms of TMD (OR = 4.38, p 0.01) and anxiety (OR = 4.97, p 0.001) were more likely to present higher CPQ 8-10 scores. Poor OHRQoL was associated with TMD (OR = 4.29, p 0.01) and depressive symptoms (OR = 4.50, p 0.001) in preadolescents. Conclusions: The data indicate that experience of oral diseases and disorders as well as psychological phenomena, such as anxiety and depression, influenced oral health outcomes in this group of children and preadolescents. Keywords: adolescent, child, oral health-related quality of life, psychological factors