My Beagle had his teeth cleaned and several teeth extracted. The vet did an initial exam and was upfront with me that she did not have an Xray unit, and would rely on a physical examination to determine if any teeth needed to be pulled. There was no upsell for pain medicatons and the entire package was explained to me in detail, including an itemized price list. I went home with antibiotic and pain meds. There were no post-surgical complications nor did it seem my canine was in any pain. I will use Dr. Kelly's again for my Beagle's next cleaning. Dr. Kelly is an experienced vet and I appreciate her cost-efficient practice for those of us who have been burned in the past!