Disclaimer: The information provided in this article is not a substitute for professional veterinary help. See your veterinarian for advice suited specifically to your dog.

If you’re like most pet parents, you probably think your dog’s stinky breath is normal, so you ignore it. But doggy breath is an indication of infection that can be deadly if left untreated.

Dental disease is one of the most widespread issues plaguing dogs today—in fact, roughly 90% of dogs will have some degree of dental disease by the time they are just three years old, and often it arises even earlier. PetMD says neglecting dental care is the #2 cause of earlier death in our dogs.

We talked to one of the world’s leading pet dentists, Dr. Brook Niemiec, who is shedding light on why dental disease is so prevalent and what you need to be asking your vet about your pet’s oral health.

We chronicled the warning signs and dangers of dental disease in the first part of this series on oral health. Now it’s time to explore a teeth-cleaning procedure done right. It’s very important to ask the right questions and make sure your dog is taken care of during his teeth cleaning, as he will be put under general anesthesia and may need to have teeth removed. More on that to come. First, let’s walk through the teeth-cleaning procedure.

Step one: Anesthesia

sundownanesthesiaSundown has his IV in place and is ready for his injection of propofol to induce anesthesia. A vet should perform a check on your dog before inducing anesthesia to make sure he’s healthy enough for it. Blood work may need to be done. Sundown checked out fine; he is young and quite healthy so he was green-lighted for this procedure. You should ask what precautions your vet takes against anesthetic complications.