The aim of this review study was to present in detail, based on the available literature, the multidirectional impact of chronic dry mouth on the success and long-term stability of implantprosthetic treatment. The analysis of clinical studies on peri-implant complications in patients with quantitative and qualitative salivary secretion disorders indicates that xerostomia disrupts the biological homeostasis of the oral environment, promotes bacterial biofilm accumulation, increases mucosal susceptibility to trauma, impairs the natural protective mechanisms of saliva, and increases the risk of developing periimplantitis 2-3-fold. Key factors conditioning the success of therapy include: patient-specific modification of the prosthodontic treatment plan, intensive oral hygiene performed by the patient alongside regular professional prophylaxis, saliva substitution using dedicated moisturizing agents, pharmacological stimulation, and shortened follow-up intervals. Xerostomia is not an absolute contraindication to undergoing treatment utilizing endosseous dental implants. However, achieving predictable therapeutic success and a significant improvement in the quality of life in this specific patient population requires a rigorous, multidisciplinary care protocol for the high-risk patient, with an emphasis on biological prophylaxis.