It is sometimes necessary to complete dental treatment on children using general anesthesia. This is especially true when the child is very young and has a large amount of treatment. We also use general anesthesia for older patients who have a hard time cooperating in the normal dental setting. We do not do this on a whim. Often, treatment is first attempted in an office setting with or without sedative medications. However, if there is a lot of work to be done, the hospital is often the best way to safely accomplish treatment.
Every day, I see young children with what is called "baby bottle syndrome". Basically, this is rampant decay on the teeth of a preschooler. According to the American Academy of Pediatric Dentistry and the American Academy of Pediatrics, parents should wean their children off of nighttime baby bottle or ad-lib breast-feeding after one year of age. The key here is no bottle during the night or right before they go to sleep. Yes, I know it's harder to say than to do. Children do not need to be fed during the night once they are over one year of age. Now, water is just fine at night, just not milk, formula, or juices. Having said that, caries is caused by bacteria. There are many risk factors, some of which we can control and some we cannot. We can't control salivary flow, immune response, etc. That's one reason some kids have such severe problems at such a young age.
Here is a short video of a hospital case. There is a lot on this video I did not show. I tried to be the cameraman and the actor. I set up things so you could see better what was going on. This is an actual patient (whose parents did give written consent. See here for Disclaimer and consent issues. His/her identity is not shown). I know there are dentists who do things a little differently and I was a little hesitant to post this. Just take it for what it is and I hope you learn something. I have to say I sounded a little different on this video as I am wearing a mask most of the time.
Another perspective from a Pediatric Dentistry Resident on: The Operating Room