HEALTH chiefs have released shocking new pictures of Southampton youngsters' rotten teeth as the debate over adding fluoride to water supplies hots up.
In one of the images, the tiny mouth of a three-year-old child is filled with blackened stumps of decaying and diseased teeth.
Dentists say distressing sights like these, which highlight the extent of the problem in the city, are becoming more and more frequent.
With nearly half of all Southampton's youngsters experiencing tooth decay by the age of five, they argue drastic action must be taken now, or the problem will get worse still.
It is the alarmingly high number of infants with rotten teeth that is driving moves to add fluoride to the city's tap water.
Health chiefs say Southampton has a depressing record when it comes to children's dental health, but high-profile schemes to educate parents have failed.
With the message about regular brushing simply not getting through, they now want to see water fluorinated in a last-ditch bid to improve the state of the city's teeth.
Last year, 522 Southampton children had to be knocked out with general anaesthetic for operations to remove more than 2,900 diseased teeth.
Campaigns in the city have included handing out toothbrushes and fluoride toothpaste to under-sixes, promoting healthy eating, improving access to dental care and daily brushing schemes in nurseries.
But these have had no impact, particularly in more deprived areas, so now Southampton City Primary Care Trust (PCT) wants to take more drastic action in a bid to improve the state of the city's oral health.
The PCT is behind the scheme to add fluoride to the water of two-thirds of the city - around 160,000 residents, as well as a further 36,000 people in Eastleigh, Totton and Netley.
Dr Andrew Mortimore, the PCT's public health director said failure to act would mean youngsters continuing to suffer from a preventable disease.
"Local dental health surveys show that oral health is poor, with 42 per cent of the city's children experiencing dental decay by the age of five," he said.
"This is totally unacceptable as it is a preventable disease."
Dr Mortimore added that studies show the results of fluoridation means the average child is likely to have two fewer decayed teeth, and about 15 per cent more youngsters would be totally free from tooth decay.
"If we do not implement fluoride, we are unlikely to see any significant improvement in oral health."