Prevalence and Severity of Tooth Wear, with an Emphasis on Parafunctional Risk, in a Clinic-based Sample of the Qassim Population: A Pilot Cross-sectional Study

Abstract Background: Tooth attrition is the accelerated form of tooth wear that arises from tooth-to-tooth contact during functional and parafunctional activities, and it may lead to dentin exposure, loss of occlusal vertical dimension, and impairment of masticatory function. However, epidemiological data on tooth wear in adults from the Qassim region remain limited. Aim: The aim of this study was to investigate the prevalence and severity of tooth wear, with particular attention to parafunctional (attrition-type) risk, in a clinic-based sample of the Qassim population, and to examine whether wear severity was associated with sex, age, or self-reported bruxism. Materials and Methods: This was a cross-sectional observational study performed at the College of Dentistry, Qassim University. One hundred and one adults (18–40 years) were recruited. All participants completed a structured questionnaire covering their demographic data and bruxism-related habits and underwent a clinical examination using the modified Smith and Knight Tooth Wear Index (TWI). Data were analyzed using descriptive statistics, Chi-square tests, independent samples t -tests, one-way analysis of variance, and binary logistic regression. Parametric assumptions were verified with the Shapiro–Wilk and Levene tests, and nonparametric sensitivity analyses confirmed the robustness of the findings. Cohen’s d effect sizes and 95% confidence intervals (CIs) are reported throughout. Results: Tooth wear was identified in 89.1% of participants (95% CI: 81.5%–94.4%), with a mean TWI score of 1.42 ± 0.87. Males showed significantly higher wear than females (1.68 ± 0.91 vs. 1.14 ± 0.76; P = 0.002; Cohen’s d = 0.64). Severity increased significantly with age (η 2 = 0.23; P < 0.001). Participants reporting bruxism had higher scores than nonbruxers (1.82 ± 0.93 vs. 1.18 ± 0.74; P = 0.001; Cohen’s d = 0.76). The mandibular anterior region was the most affected (mean = 1.71 ± 0.94). Binary logistic regression identified age (OR = 1.11; 95% CI: 1.04–1.18) and bruxism (OR = 3.42; 95% CI: 1.28–9.14) as independent predictors of moderate-to-severe attrition. Conclusion: Tooth wear was prevalent in this clinic-based pilot sample, and its severity was significantly associated with male sex, increasing age, and self-reported bruxism. Within the limits of a small, clinic-based sample, these findings should be interpreted as a localized baseline rather than a definitive profile of the general Qassim population, and they underscore the need for targeted preventive strategies and early identification of at-risk individuals.