Objective: To assess the fit between of the Romanian version of the Oral Health Impact Profile (OHIP-49) and Locker’s conceptual model of oral health. Basic research design: Cross-sectional interview study. Clinical setting: Convenience sample of hospitalized internal medicine patients, in Cluj-Napoca, Romania. Participants: 340 participants (40% male), divided in two samples, sample N1 = 165 to analyse the theoretical model, and a cross-validation sample, N2 = 175. Main outcome measures: Path-analysis was used to assess the fit between the conceptual model proposed by Locker, and the data. Results: Initial results showed an unsatisfactory fit to the data: χ² = 43.8 (df = 5, p = 0.001), χ² was found to be significant; GFI = 0.932, CFI = 0.948, TLI = 0.782, these indices presented values lower than 0.95, while SRMR = 0.053 and RMSEA = 0.22 (90% CI 0.16 – 0.28) were situated above the accepted threshold. Evaluation of the residual matrix and the modification indices lead to the respecification of the first model, obtaining an better fit of the second model: χ² = 17.63 (df = 9, p = 0.04), while GFI = 0.972, CFI = 0.988, TLI = 0.973, were above the threshold and SRMR = 0.036 and RMSEA = 0.07 (90% CI 0.02 – 0.12). Conclusions: The current study indicates that OHIP-49 represents an acceptable operationalization of the Oral Health related Quality of Life, as it was conceptualized by Locker’s theoretical model. Keywords: Quality of life, OHIP-49, path-analysis, conceptual validation