More than one in six of three-year-olds in parts of Teesside have obvious tooth decay.
Some 17.3% of three-year-olds in Middlesbrough and Redcar and Cleveland have had at least one tooth removed, a filling or tooth affected by decay.
That is higher than the England average of 11.7%, according to a survey done by Public Health England.
Sunderland is the only place in the North-east with a worse rate of tooth decay among three-year-olds.
It means that in Middlesbrough the average three-year-old has 0.53 teeth affected by decay, higher than the England average of 0.36 teeth per child.
Among children who actually have obvious deterioration in their teeth, that figure rises to over three teeth per child in Middlesbrough.
In contrast, Stockton had just 7.3% of children with obvious tooth decay.
This is the first time a survey on dental health has been done on children as young as three across England.
The data for North West England was collected in 2011, but this is the first time it has been published.
The survey was done on children who attend nurseries. If parents did not want their children to be examined they could withdraw them from taking part in the survey.
It comes just weeks after figures released by Health and Social Care Information Centre show that the rate of children in Stockton, Middlesbrough and other parts of the region requiring dental work such as fillings and root canal surgery was among the highest in the country.
The NHS data showed that children in Stockton were having a tooth filled every seven minutes on average last year and the rate in Middlesbrough was also one of the highest in England.
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