As for the dental surgery dilemma, I totally get your concerns about complications, especially with senior pups. It might be worth reaching out to a trusted vet or even a cosmetic dentist in Eastlake Ohio for some expert advice. They could give you some insights on whether the surgery would be safe for Apple, given her kidney issues.
In the meantime, it sounds like you're doing an awesome job with her diet and supplements. Keep up the good work, and hopefully, you'll find a solution that works best for Apple's health and happiness!