AREAS with high levels of dental decay in the North-East need to give urgent consideration to adding fluoride to water supplies, according to a new report.

The call for action to improve children's dental health comes from the Northern and Yorkshire Public Health Observatory, on Durham University's Stockton campus.

It follows a detailed survey of thousands of children which shows that five-year-olds in the region have worse than average dental health.

Tooth decay is related to social deprivation - those living in the poorest conditions have the highest rates of dental decay - but some areas buck the trend.

These include much of Tyneside, including Newcastle, Gateshead, and Derwentside in County Durham, which have had fluoridated water supplies since the 1960s.

Hartlepool, which has naturally occurring fluoride, has also low decay levels despite areas of high deprivation.

Health authority areas with poorer than average dental health include (figures reflect percentages of five-year-old children who have experienced decay): Tees (47.1), Sunderland (48.8), County Durham and Darlington (51.0). North Yorkshire is slightly better than the national average at 39.1 per cent.

The report, The Dental Health of Five-Year-Old Children in the Northern and Yorkshire Region 1999-2000, makes a series of recommendations.

Crucially, water fluoridation and the distribution of fluoridated milk and toothpaste is seen as vital in areas with the highest levels of decay.

The report also demands better promotion of sugar-free snacks drinks and medicines and urges dentists to take a more preventative approach among young children.