Relevance. Dental care is among the most in-demand and socially significant areas of medical care, including in childhood, as oral health directly influences the development of the dentoalveolar system and the overall physical well-being of children. A key criterion for evaluating the effectiveness of the pediatric dental care system is its accessibility. Accessibility, in turn, is determined by several factors: regional availability of qualified personnel, the convenience of clinic locations, and the effectiveness of preventive initiatives aimed at motivating families to seek regular dental check-ups. Purpose. To analyze the current situation and past experience in organizing pediatric dental care in the Russian Federation. Materials and Methods. An analysis of regulatory documents and scientific publications on the organization of pediatric dental care in the Russian Federation was carried out, including sources indexed in the Elibrary and Scopus databases. Results. The organization of pediatric dental care in Russia is based on a clearly defined regulatory framework. However, despite the presence of this framework, several systemic challenges persist. These include significant territorial disparities in access to high-quality care, inefficient resource allocation, and ongoing personnel shortages. Against this background, one of the most effective and in-demand models remains the system of school dental offices, which provides structured preventive check-ups and continuous monitoring. Nevertheless, efforts to restore this model after its widespread decline in the 1990s have progressed slowly. Another important organizational task is the need to create conditions for delivering dental care to young children and patients with special needs, which requires adapted approaches and specialized training. At the same time, family-focused education aimed at improving parents’ health literacy remains a crucial component of the overall system. Conclusions. Pediatric dental care in the Russian Federation continues to face substantial regional inequalities, workforce deficits, and predominantly formal preventive practices. Despite the effectiveness of certain existing models, addressing systemic challenges requires a comprehensive approach involving the state, the medical community, and society as a whole. Improving children’s dental health depends on coordinated efforts to modernize infrastructure, strengthen human resources, and enhance educational outreach for families.