Background: Dental neglect results in dental caries, gum disease, and contributes to chronic diseases such as heart disease, stroke, diabetes, and cancers. Poor oral health habits developed in childhood persist into adulthood and can contribute to chronic diseases. School settings are a practical platform for teaching oral health skills. Purpose: The purpose was to assess the effectiveness of school-based, primary prevention oral health interventions for children and adolescents and to examine these programs for health behavior theory applications. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement and Checklist was used in reporting systematic review data. EBSCOhost database was utilized to search interventions by applying inclusion criteria. Data extraction occurred in four distinct phases to ensure all examined interventions met acceptable standards. Results: Eight interventions satisfied the inclusion criteria. Each study utilized oral health knowledge as an outcome variable. Two of the eight interventions stated that they utilized a specific health behavior theoretical framework. Each study applied health behavior concepts. Interventions were efficacious for improving oral health knowledge. Translation to Health Education Practice: Oral health education interventions in schools appear to be effective in providing dental skills and oral health knowledge.