Signs and symptoms of temporomandibular disorders in Nigerian adult patients with and without occlusal tooth wear. A.O. Oginni, F.O. Oginni and C.A. Adekoya-Sofowora Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. Objectives: The purpose of this study was to investigate the prevalence of signs and symptoms of temporomandibular disorders in Nigerian patients with and without occlusal tooth wear, and to relate the signs and symptoms with the severity of occlusal tooth wear. Methods: One hundred and fifty patients with occlusal tooth wear, and 100 control subjects participated in this study (mean age 40.8 ±12.2 years, range 18-65 years). Exclusion criteria included patients and subjects with more than one missing opposing pair of premolars or molars, restorations covering the entire incisal edge, canine cusps and occlusal surfaces of premolars and molars. The severity of occlusal wear was assessed using the tooth wear index (TWI) designed by Smith and Knight (1984). Chi-square test was used to compare the differences in signs and symptoms of TMD. P<0.05 was defined as significant. Results: Although more females reported pain than males the difference was not statistically significant (p=0.05). Except for impaired range of movement, tooth wear patients and controls differ significantly with respect to the variables; pain report, pain on palpation, TMJ sound and deviation on opening (p<0.001). Patients with mean occlusal TWI score of ≥3 differ significantly from those with TWI score ≤2 with respect to pain on palpation and TMJ sound (p<0.001). Conclusions: Posterior occlusal wear (mean TWI scores of 3 or 4) was significantly associated with pain on palpation and TMJ sound. Hence there may be a clinically relevant risk of TMD among Nigerian patients with occlusal tooth wear. Key words: Occlusal tooth wear, signs, symptoms, temporomandibular joint disorders