The purpose of this study was to evaluate the knowledge, comfort, practice behaviors, and perceived barriers of dental hygienists in North Carolina regarding their delivery of oral health preventive services to infants and toddlers. A questionnaire was mailed to 2,000 dental hygienists randomly selected from the North Carolina Board of Dental Examiners database. The response rate was 43 percent. The majority of the respondents were female and worked in private practice. Forty-two percent reported that they delivered preventive care to infants/toddlers (action stage of readiness). Of the 58 percent who reported not delivering care, two-thirds were contemplating caring for this population (contemplation stage), but only 10 percent of these were very likely to make changes in the next six months. Those with higher comfort levels and fewer perceived practice constraints were more likely to be in the action stage. Although these dental hygienists may be willing to consider providing care, they perceived a lack of continuing education opportunities, unfamiliarity with pediatric guidelines, and their current practice situation as significant barriers. Strategies to increase comfort and diminish practice constraints for North Carolina dental hygienists should be considered to improve access to oral health care for infants and toddlers. Teaching strategies in dental hygiene education that include both didactic and clinical experiences in treating infants and toddlers could be beneficial.