Toddlers as young as two years old are having all their teeth removed and hospitals are struggling to keep up with dental surgery as sugary drinks take a huge toll on children's teeth.
A new government report on dental care has for the first time revealed the full extent of the problem: 34,000 children under 14 had teeth removed due to decay or infection in 2012.
Dental surgery services are so stretched, there are reports of waiting lists of up to 100 children at some hospitals.
In the worst cases, dentists are forced to extract a mouthful of baby teeth from preschoolers, often because toddlers are given bottles of juice or fizzy drinks.
Top dentists have vented frustrations that severe tooth decay is one of the most common and costly diseases of children, yet also completely preventable.
Auckland children's dentist Nina Vasan - who treated a three-year-old with 10 cavities last week - said it's not just a disease of the poor. She treats children of all ages and demographics.
Vasan, a Kidz-teeth paediatrician, said parents are often shocked to discover the extent of the problem.
"Parents feel really guilty because it may have been a lack of their knowledge. Sometimes parents are crying and really upset because they feel they are to blame."
A condition dubbed "baby bottle teeth decay", midnight snacks and a lack of dental check-ups are all chipping away at children's teeth.
Vasan says most parents change their habits to stop decay recurring, but a Waikato Hospital dentist says some parents are not getting the message.
Senior dentist Graham Jull spends his day performing extractions and root canals on children suffering rampant decay and infection, yet the hospital's oral surgery department still has a waiting list of 100 children at any one time.
In some cases brothers and sisters return with the same horrifying problems.
Toddlers come in with teeth so rotten from sugar that they are no longer recognisable.
"Some of them have decayed right down to the gum level so it's just roots. We can do a full clearance and take out all 20 teeth on a two-year-old."
Poor dental hygiene is often to blame.
"Parents will give them biscuits and a drink in the middle of the night to keep them quiet. That's the worst thing you can do."
NZ Dental Association president Dr Geoff Lingard said there is increasing pressure on hospital waiting lists for children needing multiple teeth pulled - and there are no signs of the situation improving.
"Dental caries [decay] is a preventable disease and for it to have advanced to the degree where the tooth becomes infected and requires an extraction should simply not happen."
Losing teeth at a young age can affect eating and speaking and cause poor self-esteem, Lingard said.
Dentures are not an option for children as their mouths grow too fast. Instead, children must wait for the second teeth to come through.
The Sunday Star-Times reported last year that adults were avoiding the dentist due to high costs, but the latest report shows children's tooth hygiene is also lacking.
The problem is also splitting communities. Debate is dividing Waikato as a number of councils vote on whether to continue adding fluoride to the public water supply.
Although the problem affects all parts of the country, Maori and Pacific Island children are more likely to suffer the pain of teeth extraction.
Chief dental officer Robyn Haisman-Welsh said severe tooth decay is one of the most common and costly diseases of childhood, despite cavities being easily preventable.
"The state of the oral health of New Zealanders has improved over the last 20 years. But we can still do more."
The Government has been investing in the oral health of children, yet some parents are not getting the message.
The majority of children and teenagers do not brush their teeth twice a day with fluoride toothpaste, according to the 2009 New Zealand Oral Health Survey showed.
Preschoolers are the worst, with just 15 per cent cleaning their teeth twice daily.
It is the first time the Ministry of Health has collected information on child cavities on an annual basis.
Maori, Pacific Island and Asian children aged between 5 to 9 were the most likely to have had a tooth removed in the past year, while boys under 5 were the most likely to miss checkups.
Children receive free dental care in New Zealand and its recommended that parents make sure checks begin from 9 months of age.
DENTAL DECAY NIGHTMARE
Auckland father Oliver Li said he is strict about his 5-year-old son Angelo's dental hygiene, but the healthy habits slip when the boy visits his grandparents.
"It's a cosmetic nightmare. The front teeth are black and you can see the erosion.
There's a lot of consequences."
If the front teeth fall out he wouldn't be able to eat properly and he says he worries his son's growth would be affected.
"I'm devastated, I just feel I didn't do a good enough job."
Li said his 10-year-old daughter had similar problems and needed a tooth removed when she was four.
The family don't have soft drinks at home and the children brush their teeth twice a day. Genetics may be partly to blame as the children's grandmother had bad tooth decay.
Dental problems can set in despite some parents' best efforts to cut sugar from the family's diet. Grace Simpson never drank orange juice or took a bottle to bed as a toddler, but the 8-year-old Auckland girl has already had two teeth removed due to decay.
"Her teeth look perfectly fine, they are white and straight," mother Natalie Simpson said.
A few weeks ago a bad toothache kept her daughter awake at night. Under local anaesthesia, a dentist extracted Grace's painful tooth on Thursday.
"She was quite upset, but she also wanted the tooth out because it was sore."
It could take four years for the adult tooth to come through and this is the second tooth to be removed.
"There is two tooth gaps and she said she feels ugly. She is only 8 years old."
Simpson said her daughter didn't always brush her teeth twice a day, but otherwise followed a strict diet.
- © Fairfax NZ News
Should fluoride in water be the responsibility of central government?