This paper reviews the range of school-based approaches to oral health and describes what is meant by a Health Promoting School. The paper then reports the results of a World Health Organization global survey of school-based health promotion. Purposive sampling across 100 countries produced 108 evaluations of school oral health projects spread across 61 countries around the globe. The Ottawa Charter for Health Promotion noted that schools can provide a supportive environment for promoting children's health. However, while a number of well-known strategies are being applied, the full range of health promoting actions is not being used globally. A greater emphasis on integrated health promotion is advised in place of narrower, disease- or project-specific approaches. Recommendations are made for improving this situation, for further research and for specifying an operational framework for sharing experiences and research.