Regular dental check-up visits are strongly recommended; the interval between check-ups varies from pet to pet and also depends on how effective the home care program is.  Hardened tartar should be removed in the clinic, as this requires the use of special instruments and equipment.  Routine periodontal treatment performed in our office includes ultrasonic scaling, subgingival manual scaling, polishing, and fluoride application.  All dental procedures in pets, including scaling and polishing, are performed under general anesthesia.  The current state-of-the-art of veterinary anesthesia is such, that this poses minimal risk.  The adverse effects of bad teeth on the overall health of the animal also greatly outweigh the anesthetic risk.