The World Health Organization (WHO) recommended the use of the "miswak" in 1986, but in 2000, an international consensus report on oral hygiene concluded that further research was needed to document the effect of the "miswak". Some of this further research has been done on a population of 203, and concluded, in turn, "that the periodontal status of miswak users in this Sudanese population is better than that of toothbrush users". Yet another comparative study conducted on a sampling of 480 Saudi Arabian adults found 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".