The aim was to analyze prevailing oral hygiene practices among urban Saudi Arabians in relation to age, gender, and socio-economic background. Structured interviews were performed with 1155 regular patients at two centers providing dental care for university and military staff and their families, respectively, in the city of Makkah. Consecutive patients were stratified according to gender and age into 6 age categories from 10 to 60 years, with 50 male or female subjects in each group at each center. Oral hygiene habits were correlated with the subject's age and gender, and analyzed statistically using a generalized linear model. It was found that 73% used a toothbrush daily, while a miswak was used daily by 65%. Significant differences were found between genders and age groups, and between the centers. Regular miswak use was more prevalent among men (P < 0.01), while women used toothbrush more than miswak (P < 0.05). Regular miswak use was more frequent at older age (P < 0.001) and tooth brushing was less prevalent. Forty-four percent of the 51- to 60-year-old patients at the military center never used a toothbrush. Regular toothbrush use was more prevalent in the youngest age groups (P < 0.001). Among the 10- to 15-year-olds, 45% at the university center used only a toothbrush, while no adolescents at the military center used only a toothbrush. We conclude that there are large differences in current oral hygiene habits among Saudi Arabians, and that these are related mainly to age and socio-economic level, and to a lesser extent gender. This should be taken into account when planning oral health strategies for different categories.