Tooth decay remains the most common chronic disease of childhood. The CincySmiles Foundation (CSF) developed an instrument to evaluate Head Start parents' knowledge of oral health care practices and to identify barriers Head Start parents face when seeking dental treatment for their children. Data from Head Start parents (n = 675) across 3 southwest counties in Ohio were collected by CSF and analyzed by a team of university researchers. The instrument elicited information about oral health care knowledge and practices from the participants. Findings from the parental oral health knowledge scale indicated oral health education programs would benefit the Head Start population. Results suggest oral health practitioners should primarily focus educational efforts on dietary behaviors, bottle feeding, and oral hygiene. Barriers to oral health care adherence of the target population were identified with lack of dental insurance emerging as the primary barrier. An analysis of variance test revealed that participants who waited until they were in pain to visit a dentist reported more total barriers, F(2, 654) = 3.415, p = 0.033. Public health educators have an integral role to play in reducing the risk factors associated with tooth decay. (Contains 2 tables.)