Objectives: The purpose of this study was to analyze the factors that affect the test anxiety among dental hygiene students, including mental health and academic self-efficacy. Methods: A self-administered questionnaire survey was conducted among dental hygiene students in a metropolitan area from July 21 to July 31, 2020, and finally, 196 copies were statistically analyzed using SPSS 21.0. Results: The mean values of mental health, academic self-efficacy, and test anxiety among the dental hygiene students were 1.47±0.41, 2.99±0.46, and 2.76±0.74, respectively. Mental health was negatively correlated with self-efficacy (r=-0.346, p<0.01) and positively correlated with test anxiety (r=0.405, p<0.01), while academic self-efficacy was negatively correlated with test anxiety (r=-0.424, p<0.001). The factors that affect test anxiety were somatization (p<0.05), anxiety (p<0.05), paranoia (p<0.05), task preference (p<0.05), and confidence (p<0.001), which are the detailed items of academic self-efficacy. Conclusions: It is necessary to develop and apply customized health programs suitable for individual students to improve their mental health, as well as develop teaching and learning methods that can improve academic self-efficacy, as mental health and academic self-efficacy are influential factors in test anxiety among dental hygiene students.