Across the country thousands of children are having large numbers of their teeth removed in hospital - many at a very early age - because they are so badly decayed.

A survey conducted for BBC Radio 4's Today programme points to the problems being worst in Scotland, with north-west England and Wales also badly affected.

Dentists blame rates of decay on an increase in sugars in the diet and poor dental hygiene.

The problem is also rife among youngsters in Bradford, where dentists have come across whole families where every child has "rampant" tooth decay.

Dr Ian Boyd, owner of Allerton Dental Practice, has worked in the city for nine years and has not seen a noticeable improvement in the oral health of youngsters. He believes that parents constantly handing out sweets and fizzy drinks to their children lies at the root of the problem.

"It is often down to poor education of the parents. As well as having a high sugar-content diet many children don't clean their teeth before they go to bed. Then there are those who have a sugary drink before they go to bed, sometimes after they have cleaned their teeth."

Carbonated drinks increase the chance of a 12-year-old suffering tooth erosion by 59 per cent and for 14-year-olds the risk is 220 per cent, according to researchers whose work has been published in the British Dental Journal. Dental erosion is caused by acidic substances such as fizzy drinks which wear down the enamel, while decay is caused by sugar reacting with bacteria in plaque.

Dr Boyd, who used to work as a senior house officer in oral surgery in a South Yorkshire hospital, says that he has in the past removed every tooth from a child's mouth, something he found very distressing.

"Everyone thinks that dentists like taking teeth out but there is nothing more distressing than taking teeth out of a child. We try to restore teeth where possible."

He adds that tooth decay is preventable and that greater awareness of how to look after teeth would help to address the problem. "We often don't see children until they are in pain. We need to see them as early as possible."

Dr Boyd points out that around 45 per cent of the population do not go to a dentist. "If adults do not go then the children won't go either. It could be that the parents have had a bad experience years ago, but techniques have moved on since then."

He believes that parents have a responsibility towards their children. "Even if parents don't want to go themselves they should take their children."

Two years ago "shocking" levels of tooth decay were found in Bradford. In a report compiled by the Northern and Yorkshire Public Health Observatory, the city's Primary Care Trust lay at the bottom of the league table of 44 PCTs with nearly 70 per cent of five-year-olds affected by decay.

But since then vast improvements are being seen as various initiatives have got under way across the district.

In one area of Bradford hundreds of children have been involved in an initiative to fight tooth decay. For the past 18 months staff from the Trident Dental Health project have been visiting baby clinics, mother and toddler groups and day nurseries in Bowling, Marshfields and Park Lane offering dental advice to parents and carers. About 300 primary schools are involved in the project. Funding for the project, from the Trident government community initiative, was secured due to the high levels of tooth decay found in the area.

Says Sharon Newton, community project worker for Trident Oral Health, based at Leeds Road Hospital in Bradford: "One of the big problems is parents giving children sugary drinks, sweets, cake and biscuits. We give advice as well as free toothbrushes, toothpaste and free-flowing feeder cups that allow liquids to pass into the mouth rather than being sucked directly on to the teeth."

The project is directed at children aged up to five, but also helps older children through schools, youth clubs and colleges. Reception year children are provided with a 'brush bus' containing labelled toothbrushes bearing the children's names. A survey is currently being carried out to find out what effect the initiative is having. "Hopefully it will have an impact," says Sharon.

Bradford Personal Dental Service's Oral health Promotion team - one of the largest and most pro-active units in England - recently received funding from Bradford City Teaching Primary Care Trust to improve the oral health of young children.

The team objectives include implementing a toothbrushing programme in primary schools and developing 'Smile with the Prophets,' a package to be used in mosques. "We are proud of our work in mosques and have made national presentations about it," says co-ordinator Sharon Walker. Cultural eating patterns and beliefs can affect oral health in children, with one example being the tendency among some ethnic groups to put children to bed with a bottle of milk to which egg custard has been added.

Valuable work is also being done with carers of special needs children. "We also produce an excellent leaflet about toothbrushing in schools ," says Sharon, adding that parents are responding well to the initiatives.

She adds that some parents have difficulty registering their child with a dentist. "We recommend that children are registered from birth but some dentists will not take them until they are two or three," she says.

Meanwhile nurseries, playgroups and schools are introducing their own initiatives to encourage good oral hygiene. Staff from Daisy Chain Nursery, a private day nursery in Chellow Dene, Bradford, have attended a 'Smiling For Life' course run by Bradford's Oral Health Promotion Unit.

"We are very conscious of children's dental health," says deputy manager Margaret Wilkes, "We give the children milk, water or very weakly diluted fruit juice, and every child in the nursery has a toothbrush." The nursery has also put up posters advising parents to register with a dentist. "When a child registers with us the parents are asked whether they have a dentist," she adds, "And if we spot any problems with a child's teeth we would inform the parents."

Progress is being made, and across Britain, initiatives such as National Smile Week, which aims to increase public awareness of the benefits of better oral health care through nationally and locally-organised events, are also making a positive contribution.

Hopefully children who have spent hours in the dentists' chair having their milk teeth filled or removed will have learned to take care of their new set, which should last most of their lives.