As Dave suggested, MV databases are really designed to work best when you know the key of the record you are trying to retrieve. Some people refer to them as record based database systems, as opposed to SQL, which is a set based database system.
It really depends on what you are trying to do, how the data needs to be structured, and what other tools you have available. I spend most of my time working in MV (Revelation products, mostly) and we handle records sets in the 10,000,000+ regularly, and the speed is fine.
The MV database strength is when the data is fluid. We find that most of our clients use it for applications like legal, medical and financial products; applications where the relationships are complex and can change rapidly and drastically over time.
You might want to look over the no SQL movement, which shares much of the same concepts, even though MV and no SQL really aren't the same thing.
The main downside of MV is less in it's structure, than it's tools. You'll generally find that since the developer base is smaller, the toolkit and help available is smaller. You might also find that the embedded basic language that most of the offerings give you lacks the object style coding you're used to. There are times even JavaScript seems like it has more functionality as a language.
Having said that, since the MV databases are primarily giant strings, the string handling of the languages are excellent. They're great for manipulating HTML and XML string directly.
I suppose the big question I have, is do you have specific questions? I'm not going to open a war saying it's like moving from Windows to Linux or a Mac, or even moving from Debian to Red Hat, but the structures and systems are different, so they have different concepts, strengths, limitations, and purposes. If you try handling a MV database like SQL (which you can), you'll find it's not the best fit. A poorly designed MV database can be an exercise in frustation. A well designed MV database can be a thing of beauty.