Housekeeping is important unless you want to live in a sh*thole. On another note it’s good practise to repair and optimise tables in MySQL databases as you’ll find efficiencies in performance and size. WP-DBManager is a well-maintained and simple to use plug-in that lets Admins carry out this function easily and it can be scheduled so that the housekeeping process is automated.
The next step of course is to schedule backups of the MySQL database for the WordPress website. BackUpWordPress (the clue is in the title) allows Admins to schedule backing up of the whole WordPress site, including database and has a simple user interface.
Maybe not sexy but definitely safe.