Government targets to improve the state of young children's teeth were missed last year, official figures show.
Efforts are being made to improve children's teeth
Office of National Statistics figures show 41% of English five-year-olds had signs of decay in their milk teeth. The target is no more than 30%.
The average child had 1.5 affected teeth - in excess of the target of just one affected tooth per child.
However, signs of obvious decay among older children aged eight to 15 were at record low levels.
The proportion with cavities in this age group fell from 42% in 1983 and 30% in 1993 to 13% in 2003.
Less ambitious targets set in Northern Ireland were also missed. Decay was found in 61% of children aged five, compared to the maximum target of 55%.
Five-year-olds in Northern Ireland had 2.6 decayed teeth on average, compared with the province's target of 2.2.
Liberal Democrat health spokesman Paul Burstow said: "These worrying figures suggest that children are not getting the dental care they need.
"These missed targets represent a missed opportunity to tackle tooth decay early on and prevent problems getting worse."
Mr Burstow said the situation was not helped by the shortage of NHS dentists.
"Ministers talk about choice, yet for many hard-pressed families the reality is that they can't find a dentist for love nor money."
The survey found that some 62% of 12-year-olds and 50% of 15-year-olds across the UK were free of any obvious dental decay. At both ages, 87% were free from
The proportion of younger children with fillings continued to fall, with 12% of five-year-olds and 26% of eight-year-olds having fillings in milk teeth.
But statistics indicated that this was because dentists were not filling as high a proportion of obviously decayed teeth as they had previously done.
Professor Raman Bedi, the Chief Dental Officer, said: "This report is very encouraging as it confirms that, in England, older children have some of the lowest levels of decayed, missing or filled teeth in Europe.
"Better dental health for all is our primary objective and we're moving dentistry up the public health agenda to make sure we achieve it.
"We recognise that in some areas of England, improvements have not been as great as in others.
"The challenge we now face is to tackle oral health inequalities and to reduce levels of tooth decay even further, particularly in younger children."
Professor Bedi said new contractual arrangements for NHS dentistry to be implemented next year would put new emphasis on oral health promotion including prevention of tooth decay.
Professor Liz Kay, Scientific Adviser to the BDA, said: "There is no doubt that there has been an overall improvement in children's dental health, but it is disappointing to see that there has been no real improvement in the teeth of the youngest children.
"The government needs to work with the dental profession and other healthcare professionals to ensure that children are not only getting access to dental services, but that they and their parents are given the best information and support to dental care."