This study aims to evaluate the impact of silver diamine fluoride (SDF) application(s) prior to dental treatment under general anesthesia (GA) on treatment types rendered to children under six years old with GA through a retrospective case control study.Baseline demographics/disease/planned treatment data and dental treatment for qualified patients were collected from electronic dental records. Patients were in divided into a SDF intervention group (N=335, 21.49%,) or non-SDF control group (N=1224, 78.51%) based on their receipt of SDF prior to GA. Statistical analysis was completed for baseline and outcome data using STATA. Student T tests or Mann-Whitney U Test were used appropriately to compare impact of pre-GA SDF application on treatment outcomes between the two groups without adjusting the baseline variable imbalance. Poisson, negative binomial, and linear regression were used in multivariate models to address the baseline variable imbalance on impact of pre-GA SDF application and analyze the effects of baseline and demographic variables on the GA treatment outcomes. There were significant differences in age, gender, pre-GA dental pain experience, pulp involvement, and planned treatment at baseline between the two groups. In a non-adjusted analysis, the SDF intervention group had significantly more crowns, but significantly fewer unplanned and total pulp therapy and dental extractions under GA (Mann-Whitney U test, P<0.05). A multi-variate model confirmed the negative association of pre-GA SDF application with total and unplanned pulp therapy and dental extractions under GA (p<0.05), but no association with crowns placed. The model also indicated a positive relationship between invasive dental treatment with patient age, planned treatment needs and GA wait-time. Our study supports SDF application prior to dental treatment under GA as a valuable tool to reduce invasive dental procedures under GA.