Probiotics and prebiotics are gaining attention in pediatric dentistry for their ability to promote oral health and manage common dental issues through microbiome modulation. Probiotics are live microorganisms, such as Lactobacillus rhamnosus, Lactobacillus reuteri, Bifidobacterium spp., and Streptococcus salivarius, that provide health benefits when consumed in adequate amounts. Their primary mechanism of action includes inhibiting pathogenic bacteria, competing for adhesion sites on oral tissues, producing antimicrobial substances, and modulating the host immune response. In pediatric dentistry, probiotics have shown significant potential in reducing the prevalence of dental caries by lowering levels of cariogenic bacteria such as Streptococcus mutans. Additionally, probiotics help in managing periodontal health by reducing inflammation, biofilm accumulation, and gingival bleeding, making them a useful adjunct in periodontal care for children. They also play a role in reducing halitosis by neutralizing volatile sulfur compounds and have been effective in managing fungal infections like oral thrush caused by Candida albicans.