The dental problems that turn up most in what has been published on the Maltese are gum disease and baby teeth that stay too long. In records from a large chain of US vet hospitals, periodontal disease was noted in 25.4% of Maltese, against 18.2% of all dogs (Wallis and colleagues, 2021, with the breed figure as reported in the veterinary trade press). The American Maltese Association also says the breed often starts losing its baby teeth later than most dogs, which changes when an owner should worry.
At the 4 to 6 pounds the US breed standard prefers, a Maltese sits firmly in the group our guide to why small dogs have worse teeth covers, and the crowding described there applies in full. The way plaque becomes periodontal disease that eats the bone around a tooth is the same in every dog too.
How little is known about Maltese teeth
Our November 2026 search of the veterinary literature turned up no study measuring how common dental disease is in the Maltese alone. What exists is a handful of figures inside bigger studies, listed below with their limits.
| Where | Dogs | What it says about Maltese |
|---|---|---|
| US vet hospital chain | Over 3 million, 60 breeds | Periodontal disease noted in 25.4%, against 18.2% overall |
| One animal hospital in Seoul, 2025 report | 130 dogs that had teeth out | 13 were Maltese, average age about 9, average 6.5 teeth removed |
| Two dental hospitals in Seoul, 2015 to 2021 | 2,201 small and medium dogs | The most common breed, averaging 2.16 teeth out for causes other than gum disease |
| 80 dogs with an oronasal fistula | Case series | 13 Maltese, the largest purebred group |
| 42 dogs having surgery for stomatitis | Case series | 7 Maltese and 3 Maltese crosses |
The US figure comes from Mars-owned researchers working through hospital records. The paper itself sits behind a paywall, so we could not check its breed table. The 25.4% comes from a breed list in the veterinary trade press that draws on this analysis, and that list gives the Yorkshire Terrier the same 25.4%. In the Seoul study by Han and colleagues (2025), the 6.5 teeth is an average from 13 dogs, give or take a standard error of 1.86, and that range overlaps every other breed in the figure. It works out at about one tooth in six of a full adult set of 42. The hospital studies also reflect who walks in, and small breeds make up most dogs in Korea, so a breed topping a case list is not proof of higher risk. A 2026 owner survey covering 12,753 dogs in the US and Canada also named the Maltese among breeds with raised odds of gum disease, without giving a figure in the paper's main text (Jemmett and colleagues, 2026).
Baby teeth that leave late
The American Maltese Association says most breeds begin losing baby teeth at about 3 and a half months, while a Maltese often doesn't start until closer to 5. That is a breed club's guidance, and we found no study that measured it. If it holds, a 4-month-old with every baby tooth still in place is often on schedule.
In records from almost 3 million US dogs, 7% had a baby tooth that failed to fall out, and the figure was 15% in breeds under 6.5 kg, or 14 lb (Wallis and colleagues, 2024). We couldn't read the paper's breed table, but the Waltham Petcare Science Institute, the research institute behind the study, names the Maltese among those smallest breeds in its summary. Our puppy teething timeline shows the usual order.
Advice on when to remove a retained tooth differs. The breed club suggests pet puppies have them taken out at spay or neuter, after 6 months, and says puppies headed for the show ring should have them out sooner if the mouth looks crowded. AAHA's 2019 guidelines take a harder line for every breed, using the word "critical" about a retained baby tooth as the adult teeth come in. If your puppy's neuter is weeks away, waiting may cost nothing. If it is months away, or an adult canine is already being pushed out of line, ask your vet about doing it sooner. Don't try it at home, since the long root can snap off in the gum.
Maltese teeth falling out
Dogs generally have all their adult teeth by about 7 months, and before that a tooth on the floor is usually a baby tooth doing what it should. The breed club calls Maltese adult teeth "very slow to come in", so a puppy can run a little behind that. In an adult Maltese, a loose or missing tooth usually points to gum disease that has destroyed the bone holding it, and the neighboring teeth are often affected too.
Maltese also appear in the case lists for two more serious problems. One is a hole from the mouth into the nose, where advanced gum disease has worn through the bone around an upper tooth. In a series of 80 such dogs, Maltese were the most common purebred and the median age was 10.7 years (Lorida and colleagues, 2025). The sign owners notice is sneezing during or after a drink, and our guide to oronasal fistulas covers the repair.
The other is stomatitis, a painful ulcerating reaction of the mouth's lining. Early reports of a Maltese predisposition were later doubted, but in a 2025 series of 42 surgical cases the authors concluded that Maltese "may be overrepresented" (Ford and colleagues, 2025). Ten dogs is too few to put a number on the risk.
Brown fur around the mouth
No other dental sign is as visible on this breed. The standard calls for a pure white coat, and saliva carries porphyrin, the same pigment found in tears, which turns fur rust-brown as it sits and dries. A dog with dental problems tends to make more saliva, so a Maltese whose lip corners or chin have started to stain may be telling you something about its mouth.
We'd treat new or worsening staining at the mouth as a reason to lift the lip that week. Look for red gum edges, a brown crust at the gumline, or a smell that wasn't there before. Plenty of Maltese with stained muzzles have nothing wrong beyond a wet beard after dinner or a licking habit, so stains alone don't diagnose anything. Wiping the muzzle after meals makes anything new easier to see.
Stains under the eyes are a different problem with different causes, and our Tearazer is made for those. It has no role in a sore mouth. If it is the tooth itself that has changed color, rather than the fur beside it, our guide to discolored teeth in dogs explains which shades need a vet.
Home care around a long white coat
No brushing trial has been done in Maltese. The evidence comes from Beagles, where weekly brushing let more plaque and tartar build up than brushing daily or every other day (Harvey and colleagues, 2015). On a Maltese, the coat gets in the way first.
- Band the topknot and any long beard out of the way first so you can see the gumline.
- Size the brush to a 4 to 6 pound mouth, which usually means a finger brush, and use dog toothpaste only.
- Do the weekly lip check at the same time as the coat comb, so it happens without a separate reminder.
A Maltese that refuses the brush can still have Caniclean, our seaweed powder, on its food. Fed at the pack amount for its weight, it helps reduce plaque and new tartar. Hardened tartar stays where it is, and the powder can't reach below the gumline. None of our published reviews names a Maltese, so we can't tell you how the breed gets on with it.
A Maltese with a thyroid or kidney condition, a pregnant Maltese and a young puppy all need your vet's OK before any new chew, topper or supplement, this one included.
Dental cleanings and the Maltese heart
A vet cleaning under general anesthesia is the only way to reach and X-ray below the gumline. For small breeds, AAHA wants the first full cleaning done by 1 year old. Anesthesia-free scaling leaves the disease under the gum untouched, which is why the American Veterinary Dental College advises against it.
The extra question for an older Maltese is the heart. Myxomatous mitral valve disease is the most common chronic heart valve disease in dogs (Lee and colleagues, 2023), and 119 of the 135 Maltese in one ultrasound study had it. Tell your vet about any murmur, cough or tiredness before a dental is booked, and ask what they would change for it. Our guide to anesthesia safety at a dental cleaning gives the wider risk in figures.
Signs a Maltese needs the vet
Book a check for red or bleeding gums, breath that stays bad, a brown crust at the gumline, new staining at the mouth with any of those, a loose adult tooth, or food dropped from one side. A puppy past 7 months with a baby and adult tooth in the same spot needs a look too.
Same-day signs are a Maltese that stops eating, a swollen face, crying while it chews, or a mouth it can't close. Sneezing whenever it drinks, a runny nose on one side, or ulcers where the lips rest against the teeth also need prompt attention.
Common questions
Do Maltese have bad teeth? They are among the breeds more likely to have gum disease on record, at 25.4% in US vet hospitals against 18.2% of all dogs, but direct research on the breed is thin.
When do Maltese lose their baby teeth? The breed club says they often start closer to 5 months, later than the 3 and a half months usual in most breeds. Dogs generally have all their adult teeth by about 7 months.
Why are my Maltese's teeth falling out? Up to about 7 months that is usually teething. A loose tooth in a grown Maltese points to bone lost around the root through gum disease, so book a vet check.
Is brown fur around a Maltese's mouth a dental problem? Sometimes. Saliva stains white fur, and sore mouths make more saliva, but many stained dogs have healthy mouths. Lift the lip and look.
References
- American Maltese Association. Official standard of the Maltese (American Kennel Club). Approved March 10, 1964.
- American Veterinary Dental College. Companion animal dental scaling without anesthesia, position statement.
- Bellows J, Berg ML, Dennis S, et al. 2019 AAHA Dental Care Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association 2019;55(2):49-69. doi:10.5326/JAAHA-MS-6933.
- American Maltese Association. Paul MA, Fierheller V. Dental issues. americanmaltese.org/dental-issues.
- Ford J, Bell C, Donovan TA, Martel D. Surgical outcomes in canine lymphoplasmacytic stomatitis, a retrospective study of 42 dogs (2012-2022). Frontiers in Veterinary Science 2025;12:1681133. doi:10.3389/fvets.2025.1681133.
- Han K, Piao Z, Park C, Rahman MM, Kim N. Prevalence, current status, and prevention of dental extractions in dogs, a retrospective study. Veterinární Medicína 2025;70(1):1-10. doi:10.17221/40/2024-VETMED.
- Harvey C, Serfilippi L, Barnvos D. Effect of frequency of brushing teeth on plaque and calculus accumulation, and gingivitis in dogs. Journal of Veterinary Dentistry 2015;32(1):16-21. doi:10.1177/089875641503200102.
- Jemmett A, Salt C, Perry LA, O'Flynn C. Risk assessment of canine periodontal disease, insights from owner-reported health questionnaires. Journal of Small Animal Practice 2026;67(8):721-733. doi:10.1111/jsap.70121.
- Kim CG, Kwon D, Lee K, Kim SE, Jo HM. Prevalence of reasons for tooth extraction in small- and medium-breed dogs. Animals 2025;15(2):224. doi:10.3390/ani15020224.
- Merck Veterinary Manual. Muylle S. Dental development of dogs (pet owner version, updated June 2025).
- Lee HJ, Park HJ, Song JH, Song KH. Correlation between the leaflet-annulus index and echocardiographic indices in Maltese dogs with myxomatous mitral valve disease. Veterinary Sciences 2023;10(8):493. doi:10.3390/vetsci10080493.
- Lorida O, Nikita GE, Chortara I, Papadimitriou S. Acquired oronasal fistulas due to periodontitis in dogs, a retrospective study of 80 cases (2019-2024). Hellenic Journal of Companion Animal Medicine 2025;14(2).
- Wallis C, Saito EK, Salt C, Holcombe LJ, Desforges NG. Association of periodontal disease with breed size, breed, weight, and age in pure-bred client-owned dogs in the United States. The Veterinary Journal 2021;275:105717. doi:10.1016/j.tvjl.2021.105717.
- Yankowicz S. Teeth troubles in tiny dogs. dvm360, February 29, 2024 (breed list for the 25.4% figures, citing Wallis 2021 and a Waltham release).
- Waltham Petcare Science Institute. Study highlights importance of regular oral examinations in extra-small dogs (names the Maltese, summary of Wallis 2024).
- Waltham Petcare Science Institute. Small dog breeds at highest risk of dental disease (18.2% overall, summary of Wallis 2021).
- Wallis C, Ivanova A, Holcombe LJ. Persistent deciduous teeth, association of prevalence with breed, breed size and body weight in pure-bred client-owned dogs in the United States. Research in Veterinary Science 2024;169:105161. doi:10.1016/j.rvsc.2024.105161.