Something needs to be done "urgently" to improve children's oral health in the Lakes area with more than 40 children under the age of 7 having teeth pulled out under general anaesthetic last year.
Lakes District Health Board community oral health service manager Juan Restrepo said children in the Lakes district had worse oral health than in other areas.
In 2014, 46 children under the age of 7 had a tooth or teeth pulled out under general anaesthetic. Of those, 37 were 5 or younger.
There were also 59 children between 6 and 16 who had a tooth or teeth pulled out.
Mr Restrepo said the health board had been concerned for some time at the state of children's teeth, and oral health remained high on the list of priorities.
He said while they were seeing some improvement they "have a long way to go and a lot of work to do" before children in the district experienced the same level of oral health as other children in New Zealand.
Mr Restrepo said there were a number of ways it could be improved -- and one of the most important was fluoridation of Rotorua's water supplies.
"There are a number of public and personal health interventions which the health board, public health and the community need to work on together."
He said the easy access and availability of sugar-sweetened drinks, fruit juices and sports drinks which contained high levels of sugar was another major issue.
"This sits on the teeth in young children causing decay."
Mr Restrepo said pulling out deciduous or baby teeth early could impact on someone's oral health for the rest of their life.
Early loss of baby molar teeth could lead to significant crowding issues in the permanent dentition.
"Unfortunately the children requiring extraction of these teeth are often from low-income families who are unlikely to be able to afford orthodontic treatment to correct these problems later."
He said there had been several changes in the community oral health service which he hoped would make a difference including new facilities and equipment, the implementation of an electronic patient management system, and a new model of care that has moved from a treatment to a prevention focus.
"The health board is working hard on early enrolment of babies into the community oral health service, tooth brushing education and distribution of toothbrushes and fluoride tooth paste to young children, pregnant women and families."
Children are enrolled in the service when they are born and are seen by a dental therapist for the first time around the time they turned one.
"Early enrolment means a child's oral health can be assessed and that they have access to programmes aimed at preventing caries, including oral health education for family/whanau and treatment as required."
He said the introduction of an electronic oral health record system would also help.
"The centralised database and client management system is seen as a key means of addressing the needs of those most at risk of poor oral health. The system is expected to revolutionise the way the Community Oral Health Service manages its patient information and clinical records."
He said it would make it possible to document, collate, analyse and report oral health data which is currently done manually.
"Once that happens, we hope to have a much better idea of what our service gaps are and set about addressing them."