Tooth decay is the most common childhood disease in New Zealand, according to the Ministry of Health - and experts blame sugary drinks.
Hawke's Bay District Health Board said it was concerned with the stubbornly high rates of decay.
Clinical Director of Oral Health Robin Whyman said it was good to see rates improving, despite the high availability and consumption of high-sugar drinks.
However, he said attitudes toward sugary drink consumption - the number one source of sugar in young Kiwis' diets - must change.
"We need to make it very clear to people that actually we need to change as a society," he said.
It's scandalous, how much unnecessary pain and suffering is caused by these sugary drinks
"I think there are some parallels with tobacco - our expectations and acceptance about the use of tobacco has changed a long way, and I think we're in a similar position around sugar, and sugary drinks in particular."
Hawke's Bay District Health Board said it would support fluoridating water in the region. A bill is before Parliament currently which would give district health boards power to instruct local councils to fluoridate water and was expected to pass.
Dr Whyman said inequality and socioeconomic factors were strongly linked with oral health in children.
He said the health board was working hard to get all preschoolers enrolled in oral health services, which were free for all New Zealanders under 18.
Currently almost nine in every 10 children in Hawke's Bay were enrolled by age five, but the enrolment rate was lower for Maori and Pacific children.
"I remain optimistic. It's been a slow improvement, but it's nevertheless been an improvement."
New Zealand Dental Association spokesperson Rob Beaglehole said the Government must implement a tax on sugary drinks, among other measures.
The World Health Organisation (WHO) recently urged governments to put a 20 per cent tax on high-sugar drinks.
The UK has committed to doing so by 2018, following France, Hungary, Mexico and Norway. Mexico's sugar tax has led to declines in consumption of fizzy drinks of 5.5 and 9.7 per cent in the first two years.
"It's scandalous, how much unnecessary pain and suffering is caused by these sugary drinks," Dr Beaglehole said.
"It's very awkward the Government is not taking note and introducing an evidence-based policy, particularly when the WHO urgently recommends all countries to adopt a tax," Dr Beaglehole said.
He pointed to the Government being very committed to adding a tax on tobacco and to reduce use.
Health Minister Jonathan Coleman said he was not yet convinced on the benefits of such a tax on sugary drinks.
"If they're not interested in reducing the pain and suffering of young children, hopefully they're interested in reducing the burden on taxpayers in terms of the amount of money this is costing," Dr Beaglehole said.
Nationally, 29,000 children aged 1-14 had teeth removed due to decay in the last 12 months, according to Ministry of Health figures. This excludes accidents and other medical reasons.
