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Purpose: As of 2011, 70% of all states (35/50) have legislation outlining criteria for the use of general anesthesia (GA) to manage early childhood caries (ECC). Criteria are inconsistent, with varying age, health and disease requirements. The purpose of this study was to compare parental and pediatric dentist criteria for treatment of dental disease under GA.Methods: This case cohort series surveyed caregivers at both a large urban tertiary hospital and also at a suburban private pediatric dental practice. Caregiver responses were compared to results from an electronic survey sent to Board-certified members of the American Academy of Pediatric Dentistry (AAPD).Results: Data were collected from 195 parents 631 dentists. Parents believe that children (a) from ages 3-4, (b) with 2-4 carious teeth or (c) requiring 2-4 extractions or restorations all immediately qualify for GA; all significantly different (PConclusion: Board certified pediatric dentists were less likely to have specific tooth number or disease-criteria for GA than parents. Most pediatric dentists referred to the AAPD guidelines for GA, with less than 10% citing state legislation as their first choice. Twenty-seven percent of parents felt they were most qualified to request GA, while 11% of parents felt physicians were most qualified.