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Amitha J Lewis,1 Chandni Sreekumar,2 N Srikant,1 Karen Boaz,1 KP Nandita,1 Nidhi Manaktala,1 Shweta Yellapurkar1 1Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 2Department of Periodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, 574 146, IndiaCorrespondence: N SrikantDepartment of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Light House Hill Road, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaTel +919611144234Email srikant.n@manipal.eduPurpose: Assessment of teeth to estimate age in the living as well as the dead is well documented in the literature. Though applied in conjunction with other parameters in Gustafson’s technique, attrition of teeth solely is an underexplored indicator for age estimation mainly in India. Most of the studies using attrition of teeth have been conducted in bioarchaeology, and in populations where studies are being conducted in forensic contexts, the results are debatable. Thus, the present study aimed to evaluate the accuracy of age estimation using the Average Stage of Attrition (ASA) method by Li and Ji in adults of the Dakshina Kannada region.Materials and Methods: This cross-sectional study assessed the degree of attrition in both maxillary and mandibular first and second molars of 136 adults of Dakshina Kannada origin (age range: 20– 70 years) according to the 10 stages given by Li and Ji to derive population-specific linear regression equations.Results: Univariate analysis of prediction of age with attrition showed a significant association of attrition score with age, stratified by sex, arch as well as in total (p-value < 0.001) with a standard error of estimate of 9.231 years. The estimated age was within ± 5 years of the actual age in 44.2% of the females and 50.0% of the males. A comparative review of 23 studies done to estimate age from attrition score clinically is documented in the manuscript.Conclusion: The findings of this study suggest that evaluation of tooth wear by the Average Stage of Attrition (ASA) method can be used as a non-invasive means to aid in the determination of age in adults of Dakshina Kannada origin. Although the error increases with age, this method provides a measurable means of seriation into older and younger categories.Keywords: tooth attrition, age estimation, forensic odontology, occlusal wear, molars