Mid-procedure you decide to use a more expensive material than you originally planned and quoted. The ethical action is to:

Correct answer: B. Provide the upgraded material at no extra charge to the patient

• A. Charging more than quoted for your own clinical decision is unfair to the patient.
• B. Correct. The patient should not bear the cost of the dentist's discretionary upgrade — provide it at no additional charge (nonmaleficence/beneficence).
• C. Reverting may compromise quality once the decision was made for the patient's benefit.
• D. Billing the insurer for the difference is improper.