BACKGROUND Dental caries is the most common childhood disease and the most frequent non-communicable disease worldwide. In developing countries, a vast majority of the caries remains unrestored. However, the severity and consequences of untreated dental caries among Nigerian children is unknown. OBJECTIVE To determine the prevalence using the DMFT/dmft index and severity of oral conditions related to dental caries using the PUFA/pufa index in suburban Nigerian children. METHODS The study population consisted of 1,266 randomly selected school children in Ile-Ife, Nigeria. Dental caries status was assessed using the DMFT/dmft index, described by WHO for epidemiological studies. The PUFA/pufa index was used to assess the clinical consequences of untreated dental caries. RESULTS The mean dmft was 0.58 for the 4-6 years age group while the mean pufa score was 0.16 for the same age group. The mean DMFT score (0.16) was highest for the 13-16 years age group, while the mean PUFA score was 0.05 for the same age group. The prevalence of dmft > 0 was highest in the 4-6 years age group (16.9 %) while the prevalence of DMFT > 0 was highest in the 13-16 years age group (7.2 %). The mean pufa > 0 was highest in the 4-6 years age group (9.2 %). The overall caries prevalence was highest in the 4-6 years age group (17.4 %). Thirty-three percent of decayed teeth in the permanent dentition and 28.2 % of the primary dentition had signs of odontogenic infections. CONCLUSIONS Despite the increase in the consumption of westernised diets by Nigerian children coupled with limited access to dental care, the prevalence was low but the clinical consequences of untreated dental caries was still high.