Kamran R, et al. – This study’s objective was to report the clinical consequences of untreated dental caries assessed using pulpal involvement, ulceration, fistula, abscess (PUFA) index and its covariates in children residing in orphanages of Pakistan. Data reported that moderate levels of decay were observed in the sample with ‘d’ component majorly responsible for the cumulative decayed, missing, filled teeth (DMFT) index. However, alarmingly 50% of the decay component (49.1%) had progressed to involve the pulp. Experiencing pain in teeth prompted dental visits. Initiation of preventive services for children residing in orphanages in Pakistan would help greatly towards lessening the burden of untreated decay.