My 4 year old is also having a steel cap put on one of his back teeth and sealants on the other three back molars. He has the same condition as mentioned in above posts where his enamel is weak or non existent on his four back molars.
These teeth have not formed properly and are very prone to decay. They can go from being ok one moment to crumbling to bits within 24 hours.
He will need an op under GA as well, right now just trying to find the $2000 we need to pay for it.
He doesn't have much sugar in his diet and brushes daily also. The dentist said 20-30% of people are born with this condition, and it's occurrence has nothing to do with anything the parents have done.
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