Introduction: The mouth is the gateway to good health but it is also the gateway to disease. Oral hygiene is one of the fundamental hygiene requirements, which should be performed from an early age. Health is a component of education, and numerous facets of health, such as diet, hygiene, exercise, etc., which must be covered in school curricula. The topics of mouth hygiene might be included in the school health curriculum. A new, simple, affordable, and interactive method of teaching children about health is known as the child-to-child approach, and it maximizes the young generation's motivation in spreading knowledge about health. This might facilitate the dissemination of information to families, the community, and other kids.

Objectives: To assess the knowledge of school children before and after the child to child approach regarding practices of oral hygiene as measured by structured knowledge questionnaire. To find the effectiveness of child to child approach on knowledge regarding practices of oral hygiene in terms of gain in mean post-test knowledge scores. To find the association of the pre-test knowledge score with selected baseline variables (age, sex, education of parents, present oral hygiene practices, attitude on oral hygiene and source of information)

Methodology: For the study, a pre-experimental one-group pre-test and post-test design was used. The samples were chosen using a simple random sampling method. In addition to these samples, 12 students were selected to function as the change agents and received oral hygiene instruction from the investigator. The gathered data was examined and analysed with the help of descriptive and inferential statistics.

Results: To determine the effectiveness of child-to-child approach in terms of gain in knowledge score on practices of oral hygiene, the data was analyzed using descriptive and inferential statistics. The findings revealed that there was a significant difference between the mean pre-test knowledge score (10.95) and mean post-test knowledge score (22.87) of study samples. The mean difference between post-test and pretest knowledge score was highly significant. The obtained value (27.235) was higher than the table value (t₆₃= 1.998), indicating that the child-to-child interaction was effective in improving the knowledge of students. There was no significant association between pre-test score and the baseline variables like age, sex, education of parents, current practices, and attitude on oral hygiene and source of information.