Half of five year olds in Stoke-on-Trent have such bad tooth decay that they have fillings or teeth missing.
Health officials say that the city is listed in the last three of the national league table but they would spend more money to improve the situation.
The primary care trust is vowing to bring in more NHS dentists and to run a programme to improve dental hygiene education by spending more money on the service. There are also calls to add fluoride to the water.
Kate Taylor-Weetman the author of the report found that on average each child had four damaged, missing or filled teeth.
She said, "Historically in Stoke-on-Trent we have had a lower number of dentists compared to the population in other areas.
"We are though getting more growth money from the government to enable us to start buying more dental services to actually provide treatment for local residents."
She added: "We're very pleased that we are actually now in a position, compared to two years ago when we had no money for dentistry, that the PCT now has money for dentistry and we're able to start developing services for local residents."
