Xerostomia and Its Association with Polypharmacy and Oral Health Status Among Elderly Saudi Individuals from an Institutional Rehabilitation Center

Background/Objectives: The percentage of elderly Saudi individuals is expected to grow significantly in the next few decades, increasing the need for geriatric oral care. However, very little is known about multiple-drug exposure, xerostomia, and oral health among elderly Saudi individuals. Thus, this study aimed to explore the prevalence of xerostomia and its association with polypharmacy and oral health status among elderly individuals from an institutional rehabilitation center in Al-Baha Region. Methods: We conducted a cross-sectional study of elderly individuals who were assessed using the Summated Xerostomia Inventory (SXI) and unstimulated whole salivary sialometry (October 2024 to February 2025). Clinical oral examinations were also conducted using the World Health Organization criteria for root caries, candidiasis, mucosal lesions and ulceration, and denture stomatitis. The Oral Health Impact Profile (OHIP-14) was used to assess the oral health outcomes. Results: Xerostomia was found in 64.7% of the patients, and the prevalence gradually rose with the number of drugs used. Oral status was significantly poorer in xerostomic participants and was associated with higher Decayed, Missing, and Filled Teeth (DMFT) scores, more root and cervical caries, greater tooth loss and edentulism, a greater burden of oral candidiasis and mucosal and traumatic ulceration, and lower unstimulated salivary flow compared with non-xerostomic participants. Higher levels of xerostomia remained independently associated with polypharmacy (adjusted OR 3.9; 95% CI 1.4–10.6). Conclusions: The findings highlight the importance of routine medication review and structured preventive dental care to reduce oral side effects of salivary hypofunction. Performing a brief xerostomia screening and incorporating oral health into multimorbid elderly individuals’ medical management should be dental public health priorities.