Purpose: Studies on the oral health status of institutionalized older adults are less prevalent than those of community-dwelling older adults, as institutionalized older adults tend to be frailer. Poor oral health in older adults has a negative impact on the quality of life and self-confidence of older people and potentially poses a financial burden on both the older adult and society in general. The objective of this study was to assess and compare the oral health status of state institutionalized older adults in Malta with that of their European counterparts. Materials and Methods: A total of 278 older adults with an average age of 83.6 ± 6.5 years from nine state institutions in Malta were randomly selected. Participants were clinically examined for caries, periodontal disease, oral mucosal lesions, and prosthetic status. Results: The oral health status of state institutionalized older adults was poor, with a very low routine dental attendance (29.3%) and, consequently, a high level of treatment need (44.4% of dentate individuals required extractions and 42.1% of dentate individuals required restorations). Only 2% of dentate individuals had healthy periodontal tissues with no clinical attachment loss over 4 mm. Edentulism among state institutionalized older adults stood at 41%. Conclusions: Institutionalized older adults from Malta have a poor oral health status comparable to institutionalized older adults from Europe in general, which poses fiscal and cultural challenges that need to be addressed by the dental community.