Dental caries is multi-factorial disease affecting a wide range of population worldwide. It is regarded as the main source of toothache and tooth loss in children as well as adult populations. Obesity in children is a major public health issue, which is ranked as the fifth top cause of mortality globally. Obesity in children is assessed by body mass index (BMI) based on gender and age. Obesogenic dietary behavior in terms of increased intake of sugars, soft drinks and fast foods in conjunction with reduced activity and exercise resulted in growing populations of obesity worldwide. Aim: To study the association between body mass index (BMI), dental caries and daily obesogenic dietary behavior using the Sweet Sugar Score (SSS) in children attending pediatric dental clinics of King Khalid University, Abha city, KSA. Materials & method: Following consent; 152 child were examined according to WHO criteria for dental caries (DMFT and dmft), scored according their sugar sweet score (Excellent = 5 or less, 10 = good, 15 or more = watch-out zone ), and BMI calculated for each child based on gender and age and ranked into either underweight (< 5th percent), normal-weight (5th-85th percent), at risk of being overweight (> 85th and < 95th percent) or overweight (> or = 95th percent). Results: Among 65 males and 87 females examined; 90.1% experienced dental caries, 16% were underweight, 71% were normal-weight, 5% were at risk of overweight, and 8% were overweight. Most of children (71%) when using sweet sugar score were categorized as "watch-out zone", 19% were "excellent", and 10% were "good". Dental caries was categorized into either (present/ absent) to test its association with both BMI and Sugar Sweet Score (SSS). Pearson Chi-Square was used to test the association between BMI, SSS and Dental caries. No association was found (p > 0.05). Conclusion: The results of the present study showed a high rate of dental caries among participants (90.1%). However, it did not support the association between dental caries, daily obesogenic behaviour (SSS) and BMI in 4-13 years old children. Mean BMI was 16.6 kg/m2, with more than two third of participants being ranked as healthy weight. 71% of participants were in the "watch out zone" with increased daily obesogenic behaviour when SSS was used.
