Background: Oral health is an essential component of nursing care, and the maintenance of oral health, through both pharmacological and non-pharmacological management, is widely employed in clinical practice to support effective oral care. In children, oral health plays a crucial role in overall wellbeing, and nurses are often among the first healthcare professionals to identify, address, and prevent oral health problems. Objectives: This narrative review synthesizes and analyzes the historical evolution and available evidence regarding the nursing role in managing oral health in children, with a specific focus on nurse-led practices. It explores how nurses contribute to prevention, early detection, education, and the implementation of oral care strategies. Methods: The review synthesized relevant studies published in English between 2001 and 2025. These studies were identified through a structured search of major scientific databases, including PubMed, Scopus, Google Scholar and ResearchGate. The review incorporated literature examining nursing interventions, oral care protocols and the effectiveness of nurse-driven approaches in pediatric settings. Results: The findings highlight the significant preventive and educational impact nurses have in the oral health management of children. Nurses play an essential role in promoting oral hygiene, guiding caregivers and implementing evidence-based practices. The review also emphasizes that nurse-led interventions contribute positively to improving oral health status, particularly when chlorhexidine (CHX) is used as part of oral care routines. Conclusion: Nurse-led interventions have demonstrated positive effectiveness in enhancing children’s oral health outcomes. Future research should focus on the development of more organized, structured interventions and explore their long-term impact to further strengthen the role of nurses in pediatric oral health management.