Dental decay remains a global issue but, in the UK, has become concentrated within the most vulnerable section of society, namely young children and the most deprived. When dental decay and subsequent infection become too severe, teeth may need to be extracted under General Anaesthetic. The aim of this work was to develop a greater understanding of the population of young children referred for a Dental General Anaesthetic (DGA) in the North West of England and to explore possible interventions that may positively impact on this group reducing the high number of children undergoing this procedure. A mixed methods approach was utilised, combining a broad scoping review, quantitative data collection and qualitative interviews. Individually these methods were used to develop a greater understanding of the issue and of the services, processes and patients involved in DGA. The methods were subsequently combined using triangulation to address potential preventative interventions that would be appropriate and acceptable to this group. Differences were observed between hospitals in treatment experiences of children across the North West of England. These included variations in the environment, hospital setting and time from referral to treatment, all of which were shown to impact on the child. The number of children experiencing a repeat DGA was also high and noted as an area that required further intervention. While DGA could be a distressing experience it was considered necessary and resulted in a positive outcome both in terms of oral health and a child’s quality of life. Improving oral health in young children who experience severe decay is a complex and challenging area. A number of interventions were identified that could reduce the need for extraction under DGA. These ranged from targeted interventions, linked to information provision and enablement to support those who are more at risk, to policy change with regard to excessive sugar in food and beverages that could have a broader impact across the population. In addition, DGA service re-designs are discussed including increased provision of prevention that may benefit children referred along this pathway and thereby reduce repeat DGA rates in the future.