TEN toddlers have rotten teeth pulled out in hospitals across the region every week, shock figures reveal.
The youngsters undergo operations under general anaesthetic for “dental caries” – infections usually caused by eating sugary food and failing to brush teeth properly.
Official statistics show 1,566 children under the age of five were treated in the North-East and North Yorkshire over a three-year period, or ten every week.
Almost all have the rotten teeth extracted - and the true picture is almost certainly worse, because the figures exclude children who have teeth pulled out in dentist chairs.
The scale of the problem has alarmed Public Health England (PHE), which has made a fresh call for fluoride to be added to tap water, to dramatically cut decay.
On average, the number of under-fives admitted to hospital is up to 45 per cent lower in areas where water is fluoridated, the organisation says.
In Hartlepool, where fluoride occurs naturally, 160.8 under-fives per 100,000 have operations – but that rate is three-and-a-half times higher in unfluoridated Middlesbrough (584.7).
But the statistics for this region lay bare what PHE also acknowledges – that the main cause of rotten teeth in very young children is deprivation.
For example, ten times more under-fives are treated in hospital in Middlesbrough than in Darlington (51.4), although the water lacks fluoride in both areas.
And unfluoridated North Yorkshire (291.6) has much lower figures than Newcastle (773.2) and Sunderland (702.0) – where the chemical is added to tap water.
Northern parts of County Durham, around Consett, Crook and Chester-le-Street, are fluoridated, but the rest of the county is not. Its rate is 203.7 under-fives per 100,000.
A PHE spokesman said: “There are a number of factors which explain the variation in hospital admissions for dental caries in children.
“But evidence suggests that fluoridating water is the single most effective step we can take to reduce tooth decay generally, both among children and adults, irrespective of personal behaviour.”
Under changes introduced two years ago, decisions rest with local authorities which are required to consult with local people first.
But no councils have put forward proposals and they are likely to be far more hostile than abolished strategic health authorities, which used to be responsible for fluoridation.
Some water has been fluoridated for more than 40 years, the level adjusted to 1mg per litre, or one part per million, in an effort to reduce tooth decay.
Health experts argue the chemical strengthens tooth enamel, making it more resistant to decay, and reduces the amount of acid produced by bacteria on the teeth.
They have dismissed claims that fluoridation causes hip fractures, aluminium in the brain and tooth stains – but the policy remains hugely controversial.
The rate of dental caries in the North-East and North Yorkshire is much worse than fluoridated Leicestershire (7.0) – but much better than Rotherham (1,550.3), the worst in England.