In December my almost 3-year-old son had stainless-steel crowns, or caps, put on 3 molars, and had a 4th molar removed, in addition to lots of fillings in his very back molars and a few front teeth (under general anesthesia in day surgery at a nearby hospital).
Ever since his first tooth came in at 3 1/2 months, we thought we had taken good care of his teeth & provided a good diet -- we were shocked that they had so much decay. We now believe our care & eating habits weren't perfect, and we have come to the conclusion that dentists usually cannot tell why most childhood tooth decay happens (poor diet? bedtime bottles? poor dental care? fever? medicine? genetic malformation? ...?).
But we are sure we made the right decision for our child. We met with/had him examined by two different pediatric dentists, one of the PDs took full-mouth x-rays, we did a LOT of research online, and we talked with a lot of people who told us stories, good & bad. It was clear that crowns & general anesthesia were the right move *for the amount of decay* our son had and his age (too much repair to do when he was awake).
We were not willing to wait more than a few months. We learned that decay moves very rapidly in primary/baby teeth -- because the enamel is much thinner. If we didn't have a dentist promptly remove the decay & protect the affected tooth material, the decay would move into the root area and eventually affect the gums and permanent teeth that are waiting for their turn.
When my son's permanent molar starts moving into place above his gap (where the baby molar was pulled), it will be time to put in a spacer to maintain the gap for the several more years before the permanent molar pushes down into place.
Nowadays he never has chewy candy (mostly to protect the crowns); we are careful to have actual snack times rather than grazing all day; WE brush his teeth twice a day; we swipe his teeth with fluoride gel daily after the bedtime brushing; and he has dental checkups twice a year. And we say a little prayer that this will make a big improvement in his chances for good dental health for the rest of his life.
Good sites: American Academy of Pediatric Dentists 1stPediatricDentist.com www.parentsplace.com/expert/dentist/ www.angelfire.com/nc/kidsdental/
Best of luck in your decision!