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The effective management of tooth wear is one of the biggest challenges faced in modern dentistry. Tooth wear can significantly impact oral health-related quality of life, yet there is no existing condition-specific patient-reported outcome measure (PROM) available to accurately capture and comprehensively measure this impact. This study aims to qualitatively explore patient perspectives of tooth wear to generate items for a condition-specific PROM. Adults referred to Newcastle Dental Hospital for management of diagnosed tooth wear were invited to participate in a semi-structured qualitative interview. Participants were purposively selected from a range of ages, genders, with varied tooth wear aetiology and severity, and at different stages of treatment. Recruitment continued until purposive sampling requirements had been met, and data saturation was reached. Thematic analysis was undertaken independently by two researchers, prior to discussion to reach agreement on the identified themes. Seventeen participants with a range of tooth wear aetiologies, severity and at different stages of treatment were interviewed. Thematic analysis produced three broad themes including psychosocial impact of tooth wear, effect on function and knowledge and understanding of tooth wear. This study demonstrates the broad impacts that tooth wear can have on patients’ oral health-related quality of life, and has generated a wealth of items to inform generation of a condition-specific PROM. Understanding how tooth wear can impact on oral health-quality of life from a patients perspective is a critical first step in generation of a condition-specific patient-reported outcome measure.