Objective: Comparing caries status and oral health behavior in rural and urban school children can reveal different etiological factors associated with dental caries, which will help in planning appropriate preventive program. Materials and Methods: The present longitudinal study was conducted among 7–9-year-old children, 200 each from randomly selected one urban and one rural school of Aligarh city. A preformed questionnaire was used to assess the oral health knowledge, attitude, and practice. Caries status was recorded using decayed, missing, and filled teeth (DMFT)/deft index. School health education was given to the same children of both the schools. These steps were repeated at 6 and 12 months. Results: By independent t-test, significant effect of dental health education was seen at 6 months (P = 0.029) and 12 (P = 0.000) months with respect to increase in knowledge score and similar significant promising results were seen for increased attitude and practice score at 6 months (P = 0.0039) and 12 months (P = 0.000) for rural group. Reduction in def score was statistically significant by Mann–Whitney U-test at 6 months (P = 0.04) and at 12 months (P = 0.03) for rural group. Conclusion: Planned health education given through lecture – live demonstration lead to reduction in the deft/DMFT score; change in the d/D component to either m/M or f/F respectively as the treatment need be; and progressive increase in the knowledge, attitude, and practice score.