A fifth of children starting primary school in Southend have suffered from tooth decay, figures show.

The British Dental Association warned "grotesque" health inequalities among children in different areas of the country are set to widen as they lose out on free check-ups and school meals during the coronavirus pandemic.

A Public Health England survey of 154 five-year-olds in Southend found tooth decay in 20 per cent of children in the 2018-19 academic year.

The latest population estimates from the Office for National Statistics show there are 2,292 five-year-olds in the area, meaning 470 may be suffering with dental problems.

Southend's rate in 2018-19 was higher than that across the rest of the East of England, with 19 per cent of five-year-olds in the region experiencing tooth decay – either present at the time of the dental exam, or evident because of missing or filled teeth.

Nationally, 18,400 five-year-olds (23 per cent) had tooth decay, and more than 1,700 children had teeth extracted.

Blackburn with Darwen, in Lancashire, had the highest rate in the country with 51 per cent of children surveyed having evidence of decay. At the other end of the scale, Hastings, in East Sussex, had the lowest rate with just 1 per cent of 210 surveyed youngsters showing signs of tooth decay.

Amid the Covid-19 outbreak, NHS England has urged dental practices to stop routine, non-urgent care until further notice, meaning five-year-olds across the country will miss out on routine check-ups in the coming weeks.

Mick Armstrong, chairman of the British Dental Association, said: "With free check-ups and school meals off the menu these grotesque inequalities among our children look set to widen.

“In the 21st century we shouldn’t accept that the oral health gap between children from wealthier and more deprived communities is inevitable.

“England has tried and tested policies to hand. Ministers must not let this service or the prevention agenda end up as casualties of this pandemic.”

Of the children that were surveyed in Southend, four (3 per cent) had to have a tooth out – suggesting that around 59 children in Southend had required an extraction, aged five or younger. As high-street dentists are unable to administer a general anaesthetic, this normally requires a hospital visit.

And with hospital tooth extractions for children aged five and under costing £836 on average, extractions in Southend may have cost the NHS around £49,300 in 2018-19.

In a report, Public Health England said dental decay among young children "remains an important public health issue."

"It leads to pain and distress, sleepless nights for children and parents, and time off school and work.

"Dental decay is largely a preventable disease. Further work to improve oral health and reduce inequalities is needed as nearly a quarter of five-year-olds had experience of dental decay, and the inequalities gap remains unacceptably high." the report said.