Background: Children aged 5 years have a number of dental caries experiences (dmft > 6) or are included in the category of severe early childhood caries (S-ECC). A child who has a relatively high caries problem can affect their quality of life. Purpose: this study was to analyze the relationship between severe early childhood caries and children’s quality of life from aspects of eating, speaking, learning, and sleeping disorders. Methods: This study used an analytical observational method with a cross sectional approach. Data analysis used Univariate analysis and bivariate analysis with Spearman test. Results: The results showed that the def-t index (S-ECC) was very high (90.3%). The Spearman correlation test showed that there was a significant relationship between the severity of early caries (S-ECC) and children’s quality of life from the aspect of eating disorders (p = 0.017). Conclusion: The def-t index (S-ECC) is very high. There is a significant relationship between the severity of early caries and the quality of life of children from the aspect of eating disorders while from the aspects of speech, learning, and sleep disorders there is no significant relationship. Keywords: dental caries, oral health, quality of life ABSTRAKLatar Belakang: Anak usia 5 tahun memiliki angka karies gigi (dmft > 6) atau termasuk dalam kategori karies anak usia dini yang parah/ severe early childhood caries (S-ECC). Seseorang yang mengalami masalah karies cukup tinggi dapat mempengaruhi kualitas hidup seorang anak. Tujuan: Untuk menganalisis hubungan keparahan karies dini dengan kualitas hidup dari aspek gangguan makan, berbicara, belajar dan tidur. Metode: Menggunakan metode observasional analitik dengan pendekatan cross sectional. Data penelitian diperoleh melalui hasil pemeriksaan secara teledentistry kepada responden penelitian. Analisis data menggunakan analisis univariat dan bivariat dengan uji Spearman. Hasil: Indeks def-t (S-ECC) kategori sangat tinggi (90,3%). Uji korelasi Spearman menunjukkan terdapat hubungan yang signifikan antara tingkat keparahan karies dini (S-ECC) dengan kualitas hidup anak dari aspek gangguan makan (p = 0,017). Kesimpulan: Indeks def-t (S-ECC) sangat tinggi. Terdapat hubungan yang signifikan antara tingkat keparahan karies dini dengan kualitas hidup anak dari aspek gangguan makan sedangkan dari aspek gangguan berbicara, belajar, dan tidur tidak terdapat hubungan yang signifikan. Kata kunci: karies gigi, kesehatan gigi dan mulut, kualitas hidup