Check out healthy mouth dog essential which is rec by boarded vet dentists and is xylitol free. It's expensive. As for dentals, my dog daisy is very high risk. I take her to the Angell animal medical center in Boston where they follow a specific protocol for her anesthesia. Before I found them, I took her for a dental done by her internist's office. The hospital wasn't a dental clinic, but they were used to caring for higher risk dogs and had appropriate equipment and personnel to stabilizer her if she needed it.
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