Once. Star has always had very clean teeth, almost no tarter buildup. At 10, she finally had to go in to have a cracked molar & a cyst on her paw pad removed, so I had her teeth cleaned, too. the vet told me he might take up to 5 out, so I was glad she only needed one removed. Jack has not had his done yet, but will have a broken tooth removed when he does go in. Vet said he doesn't like to do it unless he really has to because of the anesthetic.






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