Abraham, our local vet on Maria Ascuncion cleaned my 6 year old dog’s teeth. She was sedated. No extractions. Years ago I had 3 of my dog’s teeth cleaned at Manzanillo Animal Care. They did blood work ahead of time on dogs older than 7 years. My friend Valerie’s dog was unable to have her teeth cleaned as the blood work indicated She was in kidney distress and would have died in surgery! It was about 1/10 th of the price in Canada! They have state of the art equipment!