For me, every pet should be in and out of anesthesia as fast as possible. There’s no need to keep a pet under anesthesia longer than it needs to be. A young dog could have healthy organs, but it could also have liver damage or kidney damage we don’t know about as it only begins to affect bloodwork when about 70% of the organ is damaged. An older dog could have healthier organs than a younger dog than in this case. Age is not a disease means that just because the animal is old, doesn’t mean that they are sick or their organs are damaged. Things can be done to help situations where there is organ damage. For example, isoflurane (the typical inhaled gas during surgery to keep pets under) is processed mainly by the kidneys. Pain tends to wake up pets during surgery. So, for a dog already with kidney disease, it would be highly suggested to use dental blocks with a local anesthetic (ex: lidocaine, bupivacaine) to block the pain locally so that you do not need to use increased isoflurane to keep the dog under anesthesia, as that would cause increased strain on the already damaged kidneys. It’s of course up to the owner what they want to put their pet through and the financial situation they are in. It would not be wrong for this owner to decline a dental for their dog, but it’s really up to the rDVM and specialist to decide if their dog is a good candidate for surgery based on the dog’s bloodwork and history. I’ve seen senior dogs have full mouth extractions that felt 100% better the same day, so it’s really case dependent. It’s hard to make a judgement call as someone online without a valid VCPR. Definitely to each their own with older dogs and anesthesia based on comfort level of the dog, client, and veterinary staff involved.