Oral manifestations may be the first clinical signs of idiopathic thrombocytopenic purpura (ITP) diagnosed by a pediatric dentist. The aim of the present study was to describe oral manifestations and dental care for patients with ITP. A narrative review of the literature was performed, involving a search in the MEDLINE (PubMED) electronic database for relevant articles published in English using the following keywords: "Purpura, Thrombocytopenic, Idiopathic", "Hematologic diseases" and "Dental care". No restrictions were imposed with regard to the year of publication. The inclusion criteria were studies that addressed oral manifestations and dental management in patients with ITP. This condition is considered one of the most common blood disorders in children. Manifestations such as spontaneous or trauma-induced gingival bleeding, petechiae, hematomas, purpura and ecchymosis are reported in regions of the vestibular mucosa, lateral edges of the tongue and the junction between the hard and soft palate as well as other sites of the oral mucosa. Oral management depends on the status of the disease, which is reflected in the platelet count. Moreover, the inclusion of a hematologist on the treatment team is fundamental. In the occurrence of these manifestations, a detailed patient history is the key to successful oral treatment for these patients to avoid inflammation, gingival bleeding and infection.