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Objectives: The purpose of this study was to apply an effective oral health promotion program and effect for underprivileged lower grade students. This study attempted to resolve some oral health inequality issues by providing underprivileged children with an oral health action program designed to promote positive oral health maintenance habits. Methods: This study was carried from May to August of 2009 with 77(control group 27 subjects, experimental group 36 subjects) elementary school students selected among first to third graders attending regional welfare center's after school program in Seoul. To the control group, conventional education methods were applied. To the experimental group, newly designed program was conducted by three project experts(1 expert, 1 dentist, 1 dental hygienist). It consisted of 5 sessions and progressed with various activities. It was focused on achieving target knowledge and changing oral health behavior. In order to evaluate the designed educational program, learners' achievement was evaluated with implementing the questionnaire and one-on-one interviews. And also the oral health improvement was evaluated based on change of Patient Hygiene Performance(PHP) index. Results: Based on the results of learners' achievement, the experimental group showed the significant increment of the oral health knowledge by the relapsed time, and it maintained after finished the program(p<0.001). The patient hygiene performance index showed not significant changed(p>0.05), but 1 month later the control group showed an increment of the PHP score, but the experimental group showed a decrement of it. Conclusions: Oral health promotion program by project approach could give a long-lasting educational effect to the children and encouraged proper oral hygiene behavioral changes.