Many oral and pharyngeal cancers (OPC) are preventable. Early detection improves survival rates. Hygienists have opportunities to help reduce the oral cancer burden among their patients. OBJECTIVE The purpose of this project was to qualitatively assess North Carolina dental Hygienists' views regarding OPC prevention and early detection. METHODS Sixteen practicing dental hygienists participated in 2, 8-person focus groups. Focus groups were taped, transcribed, and analyzed qualitatively for content. RESULTS Four major themes arose: 1) The charge of the dental hygienist was not necessarily to diagnose cancer, but to recognize abnormalities and initiate referral when necessary; 2) The dental hygienist is only helpful in the tobacco cessation process if the patient has a desire to quit; 3) The dental hygienist is most effective if the patient believes the provider is genuine and truly cares about the patient's well-being; 4) There is always a need for continued education in oral cancer screenings and tobacco cessation, specifically for hands-on courses. Barriers to performing OPC exams included: financial, time, and insufficient dentist support. Barriers for dental hygienists in providing tobacco cessation counseling included: lack of patient interest, lack of patient education materials and resources, smoking parents of adolescents, personality issues, and provider-patient diversity in age, gender, ethnicity, and culture. CONCLUSIONS Dental hygienists felt their most important contribution to oral cancer control was patient education and oral cancer awareness. Professional continuing education is important and barriers need to be addressed to improve oral cancer control efforts.