Abstract Objectives To explore the pathways by which oral health literacy is associated with dental caries in adolescents, assessing direct and indirect effects of family cohesion and socioeconomic status. Methods A population‐based, representative cross‐sectional study was conducted with 740 12‐year‐old adolescents in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. Adolescents answered validated questionnaires addressing family cohesion and oral health literacy. Dental caries was diagnosed using Nyvad criteria. Two dentists underwent training exercises for the diagnosis and administration of the questionnaires ( k  > 0.80). Descriptive analysis was followed by the use of structural equation modelling to determine direct and indirect associations between the variables incorporated into the theoretical model of the study (95% CI). Results Oral health literacy (standardized coefficient: −3.472, p  < .01) and mother's schooling (standardized coefficient: −0.405, p  < .01) were directly associated with dental caries, whereas family cohesion and socioeconomic status exerted an indirect effect on the occurrence of dental caries in the adolescents. Conclusions Sociodemographic factors, family characteristics and oral health literary are associated with dental caries in 12‐year‐old adolescents.