This article reports the findings of a survey-based study conducted in 2006 to determine graduating dental hygiene students' attitudes toward ethical dilemmas in eight areas of practice: substandard care, overtreatment of patients, scope of practice, fraud, confidentiality, impaired professionals, sexual harassment, abuse, and health status. The findings, based on responses from 1,165 students at 141 U.S. dental hygiene programs, indicate that many dental hygiene students do not understand what behaviors in the patient care environment are consistent with ethical practice and which are not. Responding students believed that hygienists have a strong duty to report, intercede, or educate in areas of abuse, sexual harassment, detection of cancer, and smoking cessation. However, they were less likely to report concerns about ethical transgressions such as fraud, inadequate infection control, exceeding practice scope, and failure to diagnose disease when such disclosures could potentially threaten their employment status. Based on the results, we recommend that dental hygiene programs explore curriculum enhancements to improve students' comprehension of what constitutes fraud and other ethical transgressions and the proper reporting mechanisms.