BACKGROUND: The objective of the present study was to evaluate the prevalence of anterior and posterior tooth wear among dental patients visiting the Oral Medicine and Diagnosis outpatient department (OPD) of Bahria University Medical and Dental College, Karachi (BUMDC) and to assess the associated risk factors related to anterior and posterior tooth wear. METHODOLOGY: It was a cross sectional study conducted from January 2017 to June 2017. Total 526 participants with the chief complain of sensitivity and tooth wear were included in this study and were examined by trained dental surgeons. The examiners were trained on degree of attrition (Tooth Wear Index TWI; by Smith & Knight 1984) via using structured questionnaire. Descriptive analysis, Pearson Chi square test and ordinal regression analysis was performed on SPSS version 23for future predictions. RESULTS: In this study, tooth wear was found to be more prevalent among individuals aged 31-40 years (n=215) 40.9% and (n=145) 27.6% in those who were in social class IIIm (manual skilled workers like bus driver, carpenter etc). The prevalence of anterior tooth wear was (n=169) 32.1%, posterior (n=208)39.5% and both anterior and posterior location were (n=149) 28.3%. It was observed in this study that multiple risk factors had a significant impact on the location of the tooth wear. Majority of participants (n=409) 77.8% were practicing tooth brushing as a mode of oral hygiene with posterior tooth wear as most common finding (n=170,41.5%,P-value=0.0001). Regarding parafuctional habits, majority (n=419, 79.7%, P-value =0.0001) participants were in habit of clenching. There was a remarkable effect of gastro intestinal reflux disease (GERD) on tooth wear, (n=299) 56.8% participants had GERD, (n=147) 49.1% participants had posterior tooth wear (n=55) 18.3% had anterior tooth wear and (n=97) 32.4% had both anterior and posterior tooth wear (P-value=0.0001). There was a significant effect of oral habits (betel nuts chewing) on tooth surfaces (n=243) 46.2% participants were consuming betel quid in which (n=129) 53.08% participants were found with more posterior then anterior tooth wear (P-value=0.0001). A total of 184(75.5%) participants were consuming 5-10 packets/day of betel quid and of these 51.6% (n=95/184) participants reported with posterior tooth wear (P-value=0.0001).To assess the future predictions, ordinal regression analysis were carried out. It was observed that location of tooth wear would be effected by GERD, parafuctional habits (clenching), oral habits (betel nuts chewing) and frequency of oral habits. CONCLUSIONS: We conclude from this study that there were multiple risk factors associated with tooth wear. It was observed that posterior tooth wear, younger age group, social class IIIm, parafuctional habits (clenching), betel nut usage, history of GERD, abrasive oral hygiene practices and technique of brushing were most common findings.

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