Background <p>TW results from multiple mechanisms, including erosion (chemical loss), attrition (tooth-to-tooth contact), and abrasion (mechanical wear), represent an emerging concern among young individuals (Li MHM, Bernabé E. J Dent. 55:48-53, 2016). The severity of TW can be measured using the TW Index, which scores each tooth surface from 0 to 4. With time this mechanism can proceed to visible lesions on the tooth surface; these lesions may cause dysfunction, increase sensitivity, and disfigure facial appearance. Understanding the role of target population, behavioral, and health-related factors is vital in identifying at-risk groups and guiding preventive interventions. Clinical evaluation using an examination set aids in assessing the extent and distribution of lesions. OHRQoL refers to a broader concept that includes how comfortable individuals feel while eating, sleeping, and interacting socially as well as how their oral health influences their self-confidence and overall satisfaction with their oral health (Ipeaiyeda O et.al, Niger Med J. 64(3):327-36, 2023). Given the under-recognition of TW, especially among young populations, studies exploring its correlation with OHRQoL are necessary.</p> Aims <p>This study aims to evaluate the OHRQoL among undergraduate dental students who exhibit TW resulting from abrasion, erosion, and attrition.</p> Methods <p>A cross-sectional survey was conducted using a convenience sampling technique involving 195 undergraduate dental students aged 18 and above who presented with at least one bilateral molar occlusal contact. Participants underwent oral examinations and completed a structured, interviewer-administered questionnaire comprising six domains: demographic characteristics, clinical findings, contributory factors for TW, the OHIP-14 to evaluate quality of life, and the TW Index proforma.</p> Results <p>Among the 195 participants, 164 were females and 31 were males. Their mean age was 22.38±3.04, and most of them were final-year students (2.74±1.19). The mean of the total OHIP-14 score for the studied sample was 17.92±15.6. The highest scores were found with avoid smiling (1.61±1.54), toothache (1.44±1.38), and tense or anxious (1.40±1.37). Most dental students showed poor oral health status, while only a few reported good or neutral oral health. A significant association was found between the severity of TW and lower OHRQoL scores. Students with severe TW were more likely to have poor OHIP-14 scores compared to those with mild or moderate wear. Different types of TW erosion, attrition, and abrasion showed distinct patterns in their association with OHRQoL. </p> Conclusion <p>Our study findings suggest that maintaining adequate oral hygiene alone does not protect from TW and its resulting lesions caused by various behavioral and lifestyle factors. Most participants showed poor oral health status, and a significant relationship was observed between TW and OHRQoL. Frequent intake of acidic substances such as soft drinks, vitamin C tablets, and aspirin emerged as potential risk factors for dental erosion. Despite regular brushing, the presence of tooth stains emphasizes areas that need strong awareness and preventive focus.</p>