The article describes the reasons for the existence of the USSR practice of dental care through direct payments of the population. It was found that, despite the inclusion of dental care into a unified «budget» model of Soviet public health, the practice of paid services in the public dental hospitals existed throughout the Soviet period. According to researchers, the self-supporting organization (paid) dental clinics in the USSR was not the prerogative of public health authorities and was not aimed at «the commercialization of dentistry», and to improve the availability and quality of this type of medical care, as well as on the regulation of private medical practice in the country. Despite the ideological rejection of private dental practice, the Soviet leadership assumed its existence in mind the limited availability, poor quality and limited range of dental services in government hospitals, especially in the field of prosthetic dentistry. The role of the private sector in legal dentistry was insignificant and popular among the population did not use, wide dissemination of this kind of legal activity and has not received a serious competitor to the state dental care did not. The authors suggest that more paid services in dentistry appeared informally in public hospitals. That existed in the Soviet Union uncontrollable bodies healthcare system of distribution and the provision of dental services was the result of economic, political, and medical and social problems of the Soviet health care and was based on the imperfection of the legislation, errors of the distribution system and the psychology of people.