Young children from parts of northern NSW without fluoridated water are being hospitalised for mass extractions of rotten teeth at nearly twice the rate of other children.
Dentists and paediatricians in Lismore and Ballina say tooth decay among young children is at Third-World levels.
The situation has prompted the Australian Dental Association to urge the federal government to use its influence to force councils swayed by ''fringe groups who peddle fear … and conspiracy theories'' to embrace water fluoridation.
In a statement intended to make water fluoridation an election issue, the association's federal president, Karin Alexander, said the government needed to make fluoridation of drinking water a condition of funding for all states and territories, particularly NSW and Queensland, or face a rising tide of child dental emergencies.
''Political parties [need] to have the guts to get into the debate, show some leadership and back the science and the experts to improve the dental health of all Australians.''
Ballina dentist Stephen Enright said he knew of many children as young as three who had had all or half their rotten teeth removed under general anaesthetic in local hospitals.
''You don't have to go to Nepal to work in a Third-World environment, you just come to Ballina or Lismore or one of the northern rivers public dental clinics,'' Dr Enright said.
Figures provided exclusively to Fairfax Media by NSW Health on Friday confirmed the rate of hospital admissions for the removal or restoration of teeth among children aged up to four in the Northern NSW Local Health District was 563.5 per 100,000 children a year - about 93 children.
In contrast, the average across NSW is 331.1 per 100,000.
This district includes some towns with fluoride but most of the population resides in towns with no fluoridated water, including Lismore, Byron Bay and Ballina. A fortnight ago, Lismore voted against adding fluoride to the water, though a motion to reverse that will be debated this month. Ballina Shire Council voted to proceed, defeating anti-fluoride activists.
Byron remains opposed to the addition of fluoride. The issue is expected to be debated at the Local Government Association annual meeting next month.
It is not just the very young children who are going to hospital at high rates for mass extraction of rotten teeth, local experts say.
A few days ago, an eight-year-old child underwent a general anaesthetic at Lismore Base Hospital to have 12 rotten teeth extracted.
While there are risks associated with general anaesthetic and invasive surgery, there is no evidence fluoride is dangerous for a child, experts say.
Lismore paediatrician Chris Ingall said the rate of dental decay in the region was ''extremely high'', especially among children from lower socio-economic backgrounds.
''These are children who we have to refer to dental clinics to remove half their primary [baby] teeth because they are rotten,'' he said.
The public dental clinics cannot keep up; each has a waiting list of more than 100 children.
Dr Ingall said most people did not realise this level of tooth decay caused medical problems, including stunted growth because young children could not chew nutritious foods, and premature births.
with Linda Morris