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This study was undertaken to estimate prevalence and severity of tooth wear (TW), as well as to assess non-biological and biological risk indicators for TW outcomes in adults. A cross-sectional study, adhering to the reporting STROBE guidelines, was conducted and had a convenience sample of adults ≥18 years who had at least one bilateral posterior molar contact. A total of 570 participants, seeking consultation at the University Hospital in Brussels, Belgium were allocated to three age groups 18-34 years (n=232), 35-54 years (n=256) and ≥ 55 years old (n=79). Participants answered a self-applied questionnaire regarding socio-demographics, oral hygiene and life style behavior. The questionnaire was tested-retested (ICC=0.71). Inter-examiner reliability for clinical examinations were k=0.76-0.80. The prevalence of TW was 75% (95% CI: 71.7-78.9). Out of these patients, 42% (95% CI: 38.0-46.3) had as the primary etiological factor the process of dental erosion, while 22% (95% CI: 18.9-25.9) and 11% (95% CI: 8.6-13.9) had the process of dental attrition and dental abrasion, respectively. The severity of TW according to BEWE highest score was mild in 31%, moderate in 28% and severe in 17% of participants. The hierarchical logistic regression model for the association between risk indicators and TW irrespective of the etiology was significant for age (>35-54 yr: OR= 2.35 and ≥55 yr: OR=3.89; pmale: OR=2.03; psensitive teeth: OR=2.34; p=0.005), occlusal splint (>yes: OR=1.62; p=0.03) and acidic beverages (≥once per day: OR=1.62; p=0.044). Consumption of acidic beverages was not associated with TW having as the primary etiological factor the process of dental attrition or dental abrasion, while it was significantly associated with the process of dental erosion (>once per week: OR=1.69; p=0.043 and ≥once per day: OR=1.73; p=0.016). Medical conditions were equally associated with the latter (OR=3.11; p

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