Rotting teeth account for more than 40% of hospital tooth extractions for young children in Central Bedfordshire, according to the latest NHS data.
The Royal College of Surgeons called the figures "horrifying", while health experts are urging parents to cut down their children's sugar intake.
Between 2011 and 2018, children aged 10 and under in Central Bedfordshire had teeth removed in hospital 230 times, of which 105 were for teeth rotted by preventable decay - 46% of the total.
That gives a rate of 53 such procedures per 100,000 population. Across England, the rate is 425 per 100,000.
Professor Michael Escudier, from the RCS, said: "Tens of thousands of young children are having to go through the distressing experience of having their teeth removed under general anaesthetic for a problem that is 90% avoidable."
Children in parts of Yorkshire and the North West were the worst affected, according to the British Dental Association, with Doncaster having the highest extraction rate at five times the national average.
The BDA also said the official numbers are likely to underestimate the true scale of the problem.
Chairman Mick Armstrong said: "Children's oral health shouldn't be a postcode lottery, but these figures show just how wide the oral health gap between rich and poor has become."
He said the policies currently used in Wales and Scotland to tackle tooth decay "would pay for themselves".
Both countries have dedicated child oral health programmes, providing young children with free toothbrushes and offering daily supervised brushing sessions in nursery schools.
Mr Armstrong added: "The Government's own figures show a pound spent on prevention can yield over three back in savings on treatment."
Most children are consuming more than double the daily recommended sugar intake of five cubes, according to Public Health England, which can have a serious impact on oral health.
PHE dental lead, Dr Sandra White, advised parents to "make a swap when you next shop", replacing sugary drinks, yoghurts and breakfast cereals with low-sugar alternatives.
Brushing twice a day with fluoride toothpaste and regularly visiting the dentist can also prevent tooth decay.
Dr White added: "Small, consistent changes like these can have the biggest impact on children's teeth."
Across England, 32,000 under-11s had rotting teeth removed last year, and two out of five children were less than six years old.