I have alternated between an anesthesia dental and a non-anesthesia dental. She gets both, Dali has a vet with her when she is doing the dental and if she feels a surgical dental is needed, she is clear about it. I also brush, use the enzyme gel and give her Dentastix which have done more than the lamb necks or marrow bones ever did. Just what works for my girl. For the surgical, I am lucky in that the local denist is board certified and the anesthetist is from OSU. I still worry.