More than 33,000 young children have had decayed teeth removed in one year and the number is on the rise, new figures show.
Analysis by the Press Association shows a steady climb in the numbers of children aged 10 and under needing one or more teeth taken out in England's hospitals.
More boys than girls needed teeth out in 2014/15, with more than 14,000 children aged five and under having teeth removed.
Overall, around 128,000 children have had one or more teeth removed for decay since 2011.
The Health and Social Care Information Centre (HSCIC) data shows there were 14,445 episodes of care for children aged five and under from April 1, 2014 to March 31, 2015.
Among those aged six to 10, there were a further 19,336 cases.
Overall, more than 33,000 children were affected in 2014/15, with 33,781 cases.
This is up from 32,741 in 2013/14 and 31,275 in 2012/13. There were also 30,761 cases in 2011/12.
In 2014/15, some 15,800 episodes of care were for girls aged 10 and under, while 17,981 were for boys.
London had the most children needing hospital admission as an inpatient for tooth decay in 2014/15, with 8,362 cases.
In the North East, there were 6,672 cases, and 6,413 in Yorkshire and the Humber.
The North East experienced 1,679 cases, while the East Midlands had 1,320 and the West Midlands 1,707.
There were 1,328 cases in the East of England, 3,042 in the South East and 3,255 in the South West.
The worst hotspots were Sheffield, followed by Doncaster, Rotherham and Liverpool.
Professor Nigel Hunt, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said: "An almost 10% (9.81%) increase in the number of children being admitted to hospital for tooth extraction due to decay over a four-year period is unacceptable.
"Not only is tooth decay distressing to children and parents, it has serious social and financial implications. The need for tooth extraction continues to be the number one reason why five to nine-year-old children are admitted to hospital.
"This issue urgently needs to be addressed, especially since 90% of tooth decay is preventable.
"The problem is partly one of improving oral health education.
"The Government and dental professionals need to work together to raise awareness of the impact of sugar on tooth decay and improve children's access to NHS dental services.
"Around 40% of children still do not visit the dentist each year. Regular visits to the dentist encourage good oral health and provide rapid diagnosis and treatment to prevent children from being hospitalised due to tooth decay."