My kitty has a minor heart issue. Because of that, we begin antibiotics a week before his dental, and we use a certified Veterinary Technician, certified in anesthesia. She has taken extra education in anesthesia, several years in fact, and done a number of cases and testing. She goes to the veterinarian's office, and runs the anesthesia while my vet does the dental. It ends up costing us a little more, but is worth it for my peace of mind. She also does my dog, who has no health issues. Just another option to consider. But, yes, you need to anesthetize your pets in order to get a truly complete set of xrays and completely clean those teeth below the gum line. Very important for you pet's health