<![CDATA[Oral health is an important part of overall health, but the level of knowledge about brushing teeth among elementary school children still needs to be improved. One effort that can be done is through health education using interesting educational media, such as puzzles. This study aims to determine the effect of education using puzzle media on knowledge about brushing teeth in elementary school children. The study used a quantitative method with a quasi-experimental design of one-group pretest-posttest. The study sample consisted of 42 third-grade students selected using a purposive sampling technique. Data were collected through a toothbrushing knowledge questionnaire before (pre-test) and after (post-test) the education, then analyzed using the Wilcoxon test. The results showed that before the education, most respondents had a sufficient level of knowledge (52.4%), while after the education, most were in the good category (57.1%). The average knowledge score increased from 61.67 in the pre-test to 75.48 in the post-test, with the Wilcoxon test results showing an Asymp. Sig. value. (2-tailed) <0.05, indicating a significant difference between before and after the intervention. It was concluded that counseling using puzzle media had a positive and effective effect on improving tooth brushing knowledge among elementary school students at the SPF UPT SD Inpres Nipa-Nipa. Keywords: Puzzle media; knowledge; tooth brushing; elementary school children]]>
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