POLITICIANS have made an annoying cliche out of the concept of "choice" of schools and hospitals. But any talk of choice in the dental sector deserves reaction much stronger than irritation; here it is fast becoming a choice of take it or leave it - pay for expensive private treatment or go without.

In Darlington, one of the largest practices with a 10,000-plus list will from October treat on the NHS only children and other fee-exempt patients. There will be a knock-on effect throughout the town. At the least, hundreds of people will apply to other surgeries, many of them already closed to new NHS patients.

Elsewhere in the region, notably North Yorkshire - Northallerton, the Dales and, notoriously, Scarborough - the situation is also acute. Decisions by dentists to go private are being taken ahead of a new NHS deal for them from next April. They say they are on a treadmill to treat too many patients, that there are unreasonable restrictions on treatment available on the NHS and that changed funding makes it increasingly difficult to maintain standards.

Are they justified? The treadmill claim is supported by the waiting time for routine appointments and patients are indeed told that for specialised treatment they have to pay a lot more. But the funding issue, as ever, is subjective.

Because there is a national shortage of dentists, they have a strong negotiating chip to play against the Government. They can chose to go private knowing that, should that not work out for them, the NHS would have them back. The public interest would be served if the respective bargaining strengths were more equal.

Until output from the dental schools can be increased, much depends then on the outcome of the Government's campaign to attract dentists back into the job after maternity or other absences and to tempt would-be retirees to continue on more flexible terms.