Oral Manifestations in Children With Neutropenia: A Systematic Review

Neutropenia is a hematological disorder marked by low neutrophil counts, predisposing affected children to severe infections, including those in the oral cavity. Early identification of oral signs may facilitate timely hematological referral and intervention. This systematic review investigated oral manifestations in neutropenic children and emphasized the diagnostic role of pediatric dentists. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, five databases (PubMed, Scopus, EMBASE, Web of Science, and Ovid Medline) were searched up to April 2025, yielding 22 studies, including 19 case reports and three cross-sectional studies. The most frequently reported oral findings were chronic gingivitis, periodontitis, ulcers, and horizontal bone loss. Clinical presentation and severity varied among neutropenia subtypes. Due to heterogeneity, prevalence estimates were limited; however, one cross-sectional study reported gingival bleeding in 73.3% and mouth sores in 53.3% of neutropenic children. The review concluded that oral signs may serve as early indicators of neutropenia, but the current evidence is constrained by selection bias and inconsistent reporting. Pediatric dentists should interpret these manifestations as suggestive rather than diagnostic. Future studies should aim for standardized reporting and subtype-specific analysis to enhance the clinical value of oral indicators in neutropenia.