Abstract Background The oral microbiome is integral to paediatric oral health and disease. Next-generation DNA sequencing (NGS) technology enables culture-independent profiling of microbial communities, yet findings remain inconsistent due to methodological and population heterogeneity. Objective This review synthesised NGS-based evidence comparing the oral microbiome of children/adolescents with oral diseases and healthy controls. Design The protocol was registered in PROSPERO (CRD42025618407).