This study investigated levels of dental health knowledge and factors associated with adequate dental health knowledge in a group of black adolescents living in rural areas. Using a self-administered questionnaire, data were collected on a convenience sample of 151 black adolescents aged 10 to 18 yrs living in rural South Carolina. The mean percent correct on the dental health knowledge questions was 55.0%. Using 75% as the cutoff for adequate dental health knowledge, only 7.9% of the respondents achieved this level. Two thirds of the younger adolescents (aged 10-12 yrs) were below the median on dental health knowledge. Respondents selected dental health professionals, family, and school as the three main sources of dental health information. Results from univariate logistic regression analyses indicated that being older, having a regular dentist for routine care, and having learned about dental health from dental health professionals, family, mass media, and friends were significantly associated with adequate dental health knowledge. After adjusting for other explanatory factors, adequate dental health knowledge was associated with being older and having learned about dental health from friends. This group of adolescents seems to have limited dental health knowledge with misconceptions concerning periodontal health and caries prevention. This was especially evident in younger adolescents. Incorporation of peer dental health education in school is worthwhile to investigate as a means to enhance the dental health knowledge of these adolescents.