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The purpose of this paper is to explain the rationale and potential for the WHO health promoting schools (HPS) to improve children ' s oral health, and describe validated quantitative methodologies and qualitative approaches to measure program impact.

Critical discussion of the impact of poor oral health and potential for school-based educational intervention, and evaluation methodologies used by the authors.

Using HPS to improve oral health is relevant because dental caries and gingivitis/periodontitis negatively impact children ' s health and quality of life worldwide. WHO has called for effective community-based oral health promotion programs; intervention is simple and low cost; robust evaluation measures exist – the decayed missing filled teeth index and change in cavity rate allow quantitative comparison of oral health status; and questionnaires document changes in knowledge, practices, diet, health-related quality of life, and pain.

Poor oral health is a major health issue. Established measures to improve oral hygiene offer an achievable, low-cost HPS entry point; the “knowledge” and “healthy practices” components central to the WHO HPS model are tried and tested and multiple potential benefits are documented. Poor oral health is a non-stigmatized issue, hence intervention is readily accepted, and effective evaluation tools provide evidence of program effect over a short (two to three years) timeframe.

Oral health promotion is more affordable and sustainable than the cost of traditional restorative treatments especially in middle- and low-income countries. Success with oral health leads to confidence for expansion of HPS activities to address other health issues relevant to the school community.