Ark Naturals Brushless Toothpaste is a vet recommended dental solution for pets. Brushless Toothpaste is an easily digestible gluten free dental chew with natural herbal ingredients that help keep your pet s teeth clean between cleanings.The outer ridge of the dental chew helps to remove plaque and tartar in a safe abrasive manner. The inside of the chew has a toothpaste center that kills bacteria causing bad breath and eliminates tartar and plaque build up throughout the mouth. Chews are carefully crafted with natural breath fresheners of alfalfa cinnamon vanilla and clove.  Medium is for dogs from 20-40 LBs