The main aims of this study were, first, to estimate the need for periodontal care among adult residents of Saudi Arabia using the community periodontal index of treatment need (CPITN) and, second, to quantify the relationship between the frequency of using the 'Miswak' and the need for periodontal care. The Miswak is a stick made from the roots of the Arak tree (Salvadora persica) and is used for oral hygiene purposes by many cultures. A total sample of 480 adults aged 35 to 44 years and 65 years and older from the cities of Mecca and Jeddah was included in the study. The findings indicate that the level of need for periodontal care in the sample chosen is low when compared with the findings of similar studies undertaken in other countries. The frequent use of the 'Miswak' was associated with a lower need for treatment.