Background: The prevalence of tooth wear lesions is influenced by geographical location, socio-demographic factors and lifestyle factors/habits. The aim of this study was to determine the pattern of tooth wear lesions amongst patients presenting to the Oral Diagnosis Clinic of the Dental Centre, University of Port Harcourt Teaching Hospital, and assess the associated factors that predispose to tooth wear. Methods: This was a prospective cross-sectional study carried out over a period of 3 months involving subjects aged 18 years and above, who consented to participate in the study, and had at least 20 teeth in the mouth. Socio-demographic data and information on lifestyle factors and oral health practices that may predispose to tooth wear were collected using a self-administered questionnaire. Thereafter, subjects were examined for the presence of tooth wear. Ethical approval was obtained from the Ethics and Research Committee of the University of Port Harcourt Teaching Hospital. Data was analyzed using SPSS version 25. p < 0.05 was considered statistically significant. Results: This study examined 4203 teeth in 136 subjects, and found the overall prevalence of tooth wear lesions in this population and among the teeth examined to be 40.4% and 24.0%, respectively. Attrition was the most common tooth wear lesion, with a prevalence of 36.0%, and this prevalence increased with age. Molars were the most affected, while canines were the least affected teeth. It was uncommon in those below 30 years. Attrition was significantly associated with age (p = 0.000), marital status (p = 0.000), tooth cleaning aid (p = 0.003) and frequency of changing toothbrush (p = 0.012). Abrasion and erosion each had a prevalence of 9.6%, with a similar increase in prevalence with advancing age. Both lesions were mostly seen in molar teeth. While abrasion had a significant association with age (p = 0.003), marital status (p = 0.000), tooth cleaning aid (p = 0.026) and tooth grinding habits (p = 0.030), erosion was significantly associated with age (p = 0.001), frequency of toothbrushing (p = 0.006), and last dental visit (p = 0.017). Abfraction was the least common tooth wear lesion and was associated with tooth grinding habit (p = 0.003). Conclusion: Tooth wear lesions in Port Harcourt are uncommon in those below 30 years, with the prevalence increasing steadily thereafter. Attrition is the most common tooth wear lesion, and tooth wear lesions mostly
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