Objectives: To investigate awareness and practices among dental hygienists related to an eco-friendly transition for sustainable dental practice, and to identify barriers and policy requirements. Methods: A cross-sectional online survey was conducted with 80 dental hygienists in Korea using a structured questionnaire in which green infrastructure, knowledge, attitudes, practices, barriers, and policy requirements were assessed. Data were analyzed using descriptive statistics, chi-square tests, independent t-tests, one-way analysis of variance with Scheffé’s post hoc test, and Pearson’s correlation analysis. Results: Experience with an eco-friendly education varied significantly according to clinical experience (p<0.05). Implementation of mobile questionnaire systems (p<0.05) and light-emitting diode (LED) lighting with motion sensors (p<0.05) was more prevalent in Seoul and Gyeonggi than in the other regions. Practice scores differed significantly according to clinical experience (F=4.030, p<0.05), whereas knowledge and attitude scores did not. Attitude, and practice were positively correlated (r=0.356, p<0.05), whereas knowledge was not significantly correlated with either attitude or practice. Major barriers included, lack of information, insufficient legal and institutional support, low patient awareness, limited managerial interest, and inadequate evidence. There was a strong demand for policies that support eco-friendly certification, insurance incentives, infrastructure support, standardized guidelines, and educational programs. Conclusions: An eco-friendly transition was associated with an eco-friendly education and clinical experience. These findings suggest that sustainable dental practice can be supported by enhanced eco-friendly infrastructure, continuous education, standardized guidelines, and institutional support.