Purpose: To survey an adult population in a deprived district of Karachi, with special reference to perceived oral health. Materials and Methods: One thousand questionnaires, covering topics such as socioeconomic status, general health and oral health were distributed to the participants' homes by dental auxiliaries, and 994 were returned. The respondents were adults aged between 30 and 50 years. Women comprised 49% of the sample. Results: Over half the participants (54%) perceived that they had oral problems: esthetic issues predominated (33%), but pain (17%), cavities (15%) and difficulty chewing (8%) were also reported. Most participants (94%) had dentitions of >= 20 teeth. There was a weak but significant negative correlation between age and number of teeth (r2=0.03, p0.001). Age and female gender were significantly associated with pain, bleeding gums and periodontitis. Pain was a more frequent complaint among poorly educated subjects than among the better educated. Diabetics comprised 17% of respondents and reported higher frequencies of dental problems, bleeding gums and calculus and fewer teeth. However, after compensation for age, gender, smoking, education and income, no significant associations were disclosed. Smoking was reported by 30% of all subjects and was significantly associated with pain, bleeding gums and periodontitis. Conclusion: The survey disclosed that over half the subjects in this sample of underprivileged Pakistani adults suffered from poor oral health, including pain. Keywords: treatment needs, oral health, Pakistan