my daughter has had some yucky looking front upper teeth for at least a year. the dentist keeps an eye on them but says they are ok, just not so pretty. i guess at this point they're not cavities so it's ok to leave them alone. we could cap them but they will fall out anyway.
my older daughter also was missing enamel on her front teeth and i took her in at 2.5 for weird brown lines on her teeth. we ended up getting them fixed but they didn't have to be capped, just filled. we tried to fill them without sedation but she wasn't having it. we ended up doing sedation but it involved a pill taken at home before i think plus a shot in the office. looking back, that dentist was too pushy. he also suggested that she needed a palate-stretcher at the age of 4 because of her pacifier use. we ended up moving and her new dentist said that it would more than likely resolve itself and it did. so i wonder if it was actually necessary to fill her teeth or if we could have just watched it like we're doing with our second one.
i would just keep an eye on it like she said but you don't want it to infect his mouth if indeed they are cavities. can they pull the teeth without sedation? i remember getting teeth pulled while being awake after i got shots in my gums to numb them. they have even better numbing things now. my girls never even know when they've gotten a shot because they put on a numbing gel before they get the shot.
if you don't have a ped. dentist already, find one that has a really entertaining office for them. back in the kids waiting area, they have video game consoles, train table, dolls, and coloring.
btw, my daughters both love the dentist. my younger didn't love it until after she was 3 and then she was a perfect patient. before that, she didn't want them near her mouth.