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LWBK942-FM.qxd 6/25/11 8:45 AM Page x
 Lippincott Williams & Wilkins’
Certification Preparation
for Dental Assisting

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Dental_CertPrep_FM.indd ii 2/12/11 2:09 PM
Dental_CertPrep_FM.indd iii 2/12/11 2:09 PM
 Senior Publisher: Julie K. Stegman
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First Edition

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Dental_CertPrep_FM.indd v 2/12/11 2:09 PM
 VI C O N T R I B U TO R S A N D R E V I E W E R S

Jessica L. Fisher, CDA, EFDA, CPT, BLS, AASCJ

Director of Dental Assisting
FORTIS College, Indianapolis, Indiana

Teresa A. Macauley, CDA, EFDA, MS

Associate Professor of Health Sciences
Ivy Tech Community College, Anderson, Indiana

Diana L. Olsen, CDA, CDPMA, RDH, EFDA, MS

Coordinator and Adjunct Instructor, EFDA Program
York County Community College, Wells, Maine

Helene A. Pizzuta, CDA, RDA

Dental Program Director
American Institute, Clifton, New Jersey

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 C O N T R I B U TO R S A N D R E V I E W E R S VII

R EV IE W ER S
Leora Harty
Medical Careers Institute, Newport News, Virginia

Carole Landes
Everest University, Largo, Florida

Mark Matney
Chattanooga State Community College, Chattanooga,Tennessee

Julie Muhle
Truckee Meadows Community College, Reno, Nevada

Carrie Olewinski
Carrington College, Boise, Idaho

Diana Romero
Delta Tech, Lake Charles, Louisiana

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Dental_CertPrep_FM.indd viii 2/12/11 2:10 PM
Dental_CertPrep_FM.indd ix 2/12/11 2:10 PM
 X CONTENTS

p a r t III
Simulated Examination 77
General Chairside (GC) Practice Exam 77
Radiation Health and Safety (RHS) Practice Exam 92
Infection Control (ICE) Practice Exam 105
Answers and Rationales: General Chairside (GC) 117
Answers and Rationales: Radiation Health and Safety (RHS) 131
Answers and Rationales: Infection Control (ICE) 142

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 p a r t I
Preparing for the Dental Assisting
National Certification Exam

Note: This book covers preparation for only the DANB

The Certification Exam CDA exam.

Why get DANB certified? Why go through the hassle, the

Computerized Exam
added time, and the pressure of taking a national board
exam to prove your credentials? The answer is relatively The DANB exam is only administered as a computerized
simple. Dentists generally would like their patients to re- exam. A written version is no longer available. The test is ad-
spect and trust them and possibly even recommend them ministered year-round at over 200 testing centers across the
to other potential patients. If that isn’t the case, those den- country. Applications may be turned in at any time, and can-
tists will soon find their practices dwindling. In order to didates may schedule their exam online at any time after re-
win patients’ trust and respect, it is not enough for only ceiving their test admission notice. The exam must be taken
the dentist display a high degree of knowledge and profes- during a 60-day eligibility window. For further information and
sionalism; the entire dental staff should be held to high test center locations, visit the DANB website (www.danb.org).
expectations as well. A dentist could seek and hire quali-
fied dental assistants based on their word alone (“Sure,
I’m qualified!”), but chances are, most dentists will require The Exam Components
some documentation as proof that the candidate is, indeed, The CDA exam consists of three component exams: General
a qualified professional. To ensure a reputation of excel- Chairside (GC), Radiation Health and Safety (RHS), and Infec-
lence for themselves and for their staff, many dentists may tion Control (ICE). General information about each of these
require the national certification for employment, even exams—such as the allotted testing time, the total number
though it may not be a state requirement. Therefore, even of questions (items) in each component, and the percentage
if your state does not require taking a credentialing exam (%) of exam questions in each topic area—is provided here.
such as the DANB, obtaining and maintaining this national
credential will speak volumes about your qualifications, General Chairside (GC) Exam
professionalism, dedication, and sincerity in being a den-
■ 120 multiple-choice items
tal assistant. Frame your certificate and display it proudly
■ 90 minutes (1.5 hours) testing time
where patients can see it! Showing that you are a highly
■ Topics:
qualified professional will instill patient confidence in
● Collection and recording of clinical data (10%, 12
your abilities.
As you may already know, the Dental Assisting National questions)
● Chairside dental procedures (45%, 54 questions)
Board, Inc. (DANB) is the foremost recognized certification
● Chairside dental materials (preparation, manipula-
and credentialing agency for dental assistants and is a mem-
ber of the Institute for Credentialing Excellence (formerly tion, application) (11%, 13 questions)
● Lab materials and procedures (4%, 5 questions)
NOCA). Certification by a nationally recognized leader in
● Patient education and oral health management (10%,
dental assisting qualifications has many benefits. DANB-
certified assistants usually receive higher salaries than 12 questions)
● Prevention and management of emergencies (14%,
their noncredentialed colleagues, and DANB-certification
is a requirement for dental assistants to provide expanded 17 questions)
● Office management procedures (6%, 7 questions)
functions in many states.
The two areas of certification that are open to eligible
candidates are: Radiation Health and Safety (RHS) Exam
■ Certified Dental Assistant (CDA) ■ 100 multiple-choice items
■ Certified Orthodontic Assistant (COA) ■ 75 minutes (1.25 hours) testing time

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 2 PA R T I P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M

■ Topics: Matching items, true/false items, and questions that

● Exposing and evaluating radiographs (intraoral, could have more than one possible answer, such as “both A
extraoral) (37%, 37 questions) and B,” “None of the above,” or “All of the above,” are not
● Processing films (16%, 16 questions) used on the DANB exam.
● Mounting/labeling films (11%, 11 questions)
● Radiation safety, patient (24%, 24 questions)
● Radiation safety, operator (12%, 12 questions)
Studying Ahead for the Exam
Infection Control (ICE) Exam
■ 100 multiple-choice items One of the most important aspects of studying for an
■ 75 minutes (1.25 hours) testing time exam is not to “study” for the exam at all.Yes, you read that
■ Topics: right! But isn’t this book designed to help you study for
● Patient and dental health care worker education the test? Yes, of course it is. However, many students con-
(10%, 10 questions) fuse “studying” with “cramming” for an exam. “Cramming”
● Prevention of cross-contamination and transmission as much information into your head in a day or two—or
(20%, 20 questions) even an hour or two—before taking the exam is not re-
● Maintaining aseptic conditions (10%, 10 questions) ally “studying.” To truly study is to come prepared to each
● Performing sterilization procedures (15%, 15 questions) class throughout the academic term, read the material for
● Environmental asepsis (15%, 15 questions) that day, take notes on the material, and gain a deeper-
● Occupational safety (30%, 30 questions) than-surface-level understanding of the topic. Studying is a
wide-ranging commitment. So, to clarify the meaning of the
In total, you will answer 320 multiple-choice items in opening sentence: Don’t study for the exam, study for the
4 hours. For each component exam, there are minimum knowledge. Then review for the exam and pass. Studying
performance standards that you must meet in order to and reviewing go hand in hand.“Reviewing” for an exam is
earn the CDA certification. It is to your advantage to know going back over the material you have already learned and
the percentage of questions that will appear for each topic internalized in order to freshen it in your mind.
on the exam so that you can schedule your study time ac- A great way to begin to truly study is by implementing
cordingly. For example, you should allot more time and some long-term studying strategies and methods into your
energy to studying chairside dental procedures because student life.
these questions make up 45% (54 questions) of the GC
component exam rather than lab materials and procedures
because only 4% (5 questions) of the GC component exam Set Up Your Study Space
address that topic.
The most important thing you need to know before you
get started is what type of environment, or study space,
The Exam Questions is most conducive to your needs. Ask yourself some very
simple questions:
The DANB national exam follows strict guidelines. The ■ Where can I be most organized?
questions are written in a straightforward style with ■ What type of sounds do I like to hear when I’m learning?
simple vocabulary; they are not written to trick you into ■ When during the day am I most alert and most recep-
answering incorrectly. Strategies for answering exam
tive to new information?
questions are provided later in the section, Answering ■ How do I best learn?
Exam Questions.
The exam is written in a simple multiple-choice format, Some people think the dining room table is a great
which asks you to answer in one of two ways: place to study (and for them it might be), because it may
■ Direct-question format: You must answer a direct ques- be large and desklike. However, if that means having to
tion by choosing one BEST or MOST CORRECT answer put away all study materials at every mealtime or trying to
from a choice of possible answers. study in the center of a large and/or loud household, it may
■ Incomplete-statement format: You much complete an actually be the least conducive place. Find a space where
open-ended statement by choosing one BEST or MOST you can be consistently organized and where your high-
CORRECT word or phrase from a choice of four pos- lighters, notebooks, a computer (if necessary), textbooks,
sible answers. and other study materials can stay and be easily and readily
■ Negative format: The DANB exam does not contain accessible. Your study space should also not be cluttered
many of these types of questions, but it does contain with other items that could possibly be a distraction, such
a few. These are questions in which you must find an as phones, pictures, hobbies, magazines, and the like.
EXCEPTION or determine which choice is NOT appro- Many instructors have argued for studying in a noiseless
priate for the question. room.That seems to make a lot of sense—fewer distractions,

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 P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M 3

comfortable, and quiet. However, this may not work for time of day. What you put into your body and what type
you at all. Utter silence can be deafening and distracting of stress you place on your body directly affect how ef-
in itself to some people. If you know that you concentrate ficiently your mind works, how readily you absorb infor-
better when listening to soft music in the background, by mation, and how accurately you retain and recall material.
all means, do that. (Just be sure that the sound level is truly Eating right, exercising, getting enough sleep, and taking
beneficial to studying, not to dancing and singing along.) frequent relaxation breaks will help the knowledge be
By the same token, if you like the sounds of nature, study absorbed.
outside (weather permitting), but go elsewhere if you be-
come distracted by sounds of lawnmowers and heavy traf-
fic. Maybe an indoor room with the window slightly open The Process of Studying
would serve you better. In the end, you know best what
When you have considered all these options, then you are
works for you.
ready to get down to the business of studying. Obviously,
you should study your dental assisting textbook. Focus
your reading by asking questions and answering those
Set Up a Study Method questions while you read.Think:
It is important to be aware of how you learn best. If you ■ When will I most likely need to use this fact, procedure,
are an auditory learner—you prefer to hear the informa- or idea?
tion spoken—consider reading your information or text ■ How would this be phrased as an exam question?
into a recording device and playing back for yourself. This ■ What is the next step in this procedure? How does it
means you can study while driving, jogging, or even while relate to the step before?
taking the dog for a walk! If you are a visual learner—pre- ■ Does this make sense?
ferring to see a visual representation of the material—then
If it helps you, write down the questions (and answers).
draw some pictures of the material. If you are not an art-
If you come across a question for which you have no an-
ist, take photographs. Need to memorize lab materials and
swer, ask your instructor during the next class. This brings
proper procedures? Take pictures of them and use those as
us to the topic of taking notes.
flashcards. If you learn best by discussing the material to
Whether you are in class or reading alone, there are
be learned, join or create a study group with other vocal
many ways to take effective notes. The method you
learners. You could also explain the material to an inter-
use depends on the purpose for the note taking (build-
ested friend or relative, or even to your pet. (Don’t laugh,
ing vocabulary, memorization of facts, understanding a
it works!) In short, get creative. You know how you learn
concept, etc.) and on your style of learning. A few of the
best. However, if you have any question about it, there are
most popular note-taking styles are:
a number of free online sites (such as www.learning-styles- ■ Cornell method:The notebook page is divided into two
online.com) that will test your learning style and give you
sections, with the left section approximately 2" wide.
results with suggestions for how to make your learning
Notes are recorded on the right side, and correspond-
style work for you.
ing vocabulary, important concepts, and key words are
listed on the left. A brief summary is usually written at
the bottom of the page.
Set Up a Study Schedule ■ Outline: Topics and subtopics are carefully aligned and
Are you most alert in the morning, afternoon, or evening? indented according to how the information relates
This is the time when your mind is most receptive to new to the facts before it. Because of the formal structure
and challenging thoughts, so you should schedule your of an outline, it is not always the most effective note-
study sessions for those times. If this is not a realistic op- taking method for lectures or in-class notes (unless the
tion because of your work schedule, school, or other obli- instructor also uses an outline to teach). While taking
gations, try to get as close as possible to your ideal time or “live” notes in class, it may be best not to use the Roman
work out a study schedule in which you can study at your numeral and letter/number format because that makes
best time at least two to three times a week. it impossible to later add important information to the
Carving out time to study from your other activities is a outline; instead, use bullets, dashes, and indentions to
must, and creating a study schedule will help you stick to mark subtopics.
a routine and build great study habits. As you create your ■ Mapping: A central idea, concept, or piece of informa-
study schedule, don’t forget to include break times of 5 to tion is written in the center of the page and corre-
10 minutes every 45 minutes or so.Your brain needs down- sponding ideas or subtopics are branched out from it
time to absorb new information, and your body needs a via connecting lines. This method is useful when learn-
break to relax and de-stress from studying. ing a complex concept or theory and is great for visual
Make sure that you don’t schedule your study time im- learners because colors, drawings, or small graphics are
mediately after a heavy meal or after a hectic or stressful easily integrated into the notes.

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 4 PA R T I P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M

No matter which methods you use—or if you create ❍ “First . . . Next . . . Last . . .”
your own—there are some important principles to follow ❍ Raising the voice or emphasizing words
to make any note-taking style more effective. ❍ Pointing out items on a chart, in an outline, or

even in the text

❍ Moving closer to students

General Guidelines for Note Taking ❍ Repeating words or phrases (sometimes several

times)
■ Always: ❍ Writing information on the board, overhead trans-
● Choose a note-taking method that works for your
parency, etc.
learning style and for the topic. ● Ask questions. Some instructors ask you to wait until
● Date and number all your notes.
an appointed time, such as after a demonstration or
● Leave some empty space in case you need to fill in
instructional video or even at the end of class, to ask
more information later.
questions.
■ Before class: ● Use common sense. If you are the only one who does
● Read the material thoroughly before class, highlight-
not fully understand something, perhaps it’s better
ing important information, making notes in the mar-
to wait until after class to ask. Find out what your
gin, and indicating questions for the instructor. The
instructor prefers.
class will make much more sense and you’ll be ready ■ After class:
to ask questions about items that are confusing to you. ● Review your notes as soon as possible after class, fill-
● Write down unfamiliar terms and look them up;
ing in notes, clarifying ideas, and writing down addi-
make sure you understand the appropriate defini-
tional questions to ask the instructor or research on
tion and how it relates to your topic—for example, a
your own.
crown has a much different meaning to you than it ● Use the shorthand you’ve developed to point out
does to a member of royalty.
key terms, important points, confusing concepts, etc.
● As you take notes, write in your own words, not those
● Summarize the notes using just a sentence or two
of the instructor or textbook. Summarizing, para-
and highlight the summary. It will prove useful when
phrasing, and even listing information help make
creating a study plan for your exam.
sure you understand and internalize the information
and make studying and reviewing more user-friendly. Great note taking will only get you so far.To really know
● Develop and use your own shorthand symbols to your subject deeply and be able to pass an exam means
later draw your attention to important points (!), you also need to review your notes on a regular basis. Reg-
questions you have about a point/topic (?), or items ular review helps ensure that you understand the material
that need to be memorized (*). Visual symbols will and cuts down dramatically on the amount of time you’ll
not only help you quickly locate and identify the ma- need to study and review immediately before the exam.
terial in question during class (questions to ask) but After all, you will have been studying all along!
also after class while reviewing and adding to your Lastly, use all available tools to check your understanding.
notes. The symbols used in the parentheses are sim- Part II of this text contains a content review outline inter-
ply examples of shorthand symbols. Feel free to be spersed with review questions. Read through the outline,
creative or use whatever is most effective for you. highlight important information, compare your study notes
● Bring your notes and questions to class and review with the outline, and quiz yourself using the review ques-
them before class begins. tions. If you find that you need more preparation in certain
■ During class: areas or that some concepts are still a little vague, go back
● Sit where there are the fewest distractions, where to your textbook to clarify.After you feel you have mastered
you can hear the instructor clearly, and where you the material, use the simulated exam and scoring guide in
can clearly see any notes or demonstrations the in- Part III of this text and on the accompanying CD to test your
structor provides. exam readiness. If you do well, give yourself a well-deserved
● Listen for content key words that are specific to the pat on the back. If you don’t perform as well as you had
subject.Write down all vocabulary and important facts. expected, don’t despair and don’t give up. These are study
● Pay attention to clue words and the instructor’s physi- tools for you to measure your readiness to take the formal
cal cues that let you know something important is com- exam—they are not end results. Whether you score high,
ing up that you should write down. Some examples of medium, or low on the review questions, use the rationales
instructor’s verbal and nonverbal cues and clues are: as an additional tool to better understand any questions
❍ “Three important safety regulations . . .” (a list is you missed and to verify and solidify the correct answers
coming up) you had. Then make a list and formulate a study plan and
❍ “Most importantly . . .” schedule to help you focus on the areas in which you had
❍ “The advantages and/or disadvantages to this . . .” trouble. Remember, studying is a cycle, not a linear process.

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 P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M 5

the information you’ve put into it. If you’ve done your

Preparing for the Exam work all along and internalized the information, the
knowledge will be there.Trust in yourself.
■ Eat small, nutritious, well-balanced meals several times
It is very important to prepare yourself physically and psy-
chologically for the exam itself. Arriving at the test center every day. Feed your body and your mind so you can
weak, worn out, tired, frazzled, or otherwise unhealthy is function at optimal level.
not going to help you pass that exam. So what’s the best
way to prepare? By being proactive, of course! The Day Before the Exam
This is not a time for cramming. You may want to take
Avoid Test Anxiety some time to review, but relaxation and positive attitude
Many people experience a snowball effect of fear, stress, building should be your primary concern. If you haven’t
and anxiety by worrying about how their test anxiety will done so already, drive to the test center at about the same
affect their exam score, increasing their anxiety even more. time of day as on the day of the exam in order to judge traf-
If you are one of those people, take a deep breath when fic patterns, time delays, etc.This will help ensure that you
you catch yourself becoming anxious. Remind yourself allow adequate time to arrive on time at the exam center
that you have been studying and preparing for the test all destination. Locate where you will park, identify the cor-
along. Focus on the positive and build up your confidence rect entrance, etc. You should also make sure that there is
instead of tearing it down. Try writing positive messages plenty of gas in your vehicle to get you to the location.You
on sticky notes and posting them around your living space. do not want to be late, hurried, or confused before you
Be your own cheerleader and recruit family, friends, and even step foot in the testing center.
fellow students to be your cheerleaders.
The Night Before the Exam
Several Days Before the Exam ■ Have a light, nutritious dinner. You want to make sure
■ Your knowledge of the material should be very solid at you sleep well before the test. Heavy dinners, alcohol, or
this point. Even though you are past the point of learn- extremely spicy foods can interfere with a good night’s
ing major new concepts, continue to stick to your study sleep. Avoid them.
schedule and focus on strengthening any areas in which ■ Decide what you will wear. Choose light, comfortable
you feel weak and reviewing those areas in which you are clothing that won’t detract your attention. If you get
strong. Don’t try to memorize the information—own it! chilled easily, plan to bring a light jacket or sweater.
■ If you haven’t already done so, make flashcards for the ■ Gather the necessary items you’ll need to bring with
various components on the exam. Use the flashcards you and place them where you will not forget them on
yourself as a quick check throughout the day or ask sup- test day:
portive family members and friends to quiz you periodi- ● Two forms of valid identification

cally as you have dinner, chat on the phone, etc. Make it ● Any additional paperwork you may be required to

a fun game, not a stress-filled obligation. bring

■ Take a practice test—in fact, take more than one. Be- ■ Plan to get the optimum amount of sleep for you. For
come familiar with the layout of the exam, the format most people, that is between 6 and 8 hours. However,
of the questions, and the wording of the directions. But for some, 8 hours can be either too much or not quite
remember that no practice test can include all the ques- enough.
tions on the actual exam or ones similar in phrasing. ■ Check your attitude and build yourself up. This is not a
Study the material, not the specific practice questions. night for cramming or studying. It’s a night for relaxing
■ Consider completing the DANB online tutorial (avail- and boosting your confidence.
able for download at http://www.danb.org/exams/tuto-
rial2.asp) before you get to the test center. It describes
how to mark your answers, skip items, and return to
The Morning of the Exam
questions. You can also take the tutorial at the test site At this point, you should be well prepared for the exam.
immediately before you begin the test—it does not You’ve laid out your clothes, assembled all required ma-
count toward your testing time. Going through the tu- terials, ensured you know how and when to get to the
torial twice will ensure you haven’t missed anything. test center, and gotten a good night’s rest. All that is left
■ Get plenty of sleep (at least 6 to 8 hours a night).A tired to do is get dressed, eat a light and nutritious breakfast,
mind does not function well. including some protein, and build up a positive can-do
■ Try to relax as much as possible and don’t spend every attitude. Leave yourself plenty of time to get to the test
waking hour studying. Allow your mind to process all center, arriving at least 5 minutes early. If you think better

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 6 PA R T I P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M

after a morning cup of coffee, then by all means, indulge a ■ Eliminate “wrong” answers right away. Just be careful
little, but be careful not to consume too much caffeine— not to do this too quickly; you don’t want to eliminate
you don’t want to be jittery or anxious—or consume too the right answer. Read, evaluate, and think through
many liquids. Testing time does not stop while you use the choices.
the restroom! ■ If you find you really do not know an answer at all, try
to eliminate as many of the wrong choices as possible
to increase your chances of getting the right answer
During the Exam and then take your best educated guess; you will not
be penalized.
As difficult as it may seem, you need to try to relax. Focus
on your breathing; don’t hold your breath. Also, try to sit Practice using these tips as you answer the review ques-
in a comfortable, upright position, leaning slightly forward. tions in this text and on the accompanying CD.
Being hunched over will only serve to give you a backache
and remind you how uncomfortable you are. Don’t sit still Strategies for Taking the Exam
too long. Move your legs and arms from time to time and
■ Take the online tutorial available at the test center be-
rotate your shoulders. Try to keep your blood circulating.
fore you begin your exam, even if you’ve taken it else-
Use the tips and strategies provided in the following sec-
where online already.
tions to improve your test-taking abilities.
■ Budget your time and don’t spend too much time on
any one question.
Tips for Answering Exam Questions ■ Conversely, don’t hurry.Try to use every bit of time you
The exam is written using simple multiple-choice ques- have available for your exam.
tions.This does not mean that the questions themselves are ■ Use the restroom if necessary, but remember that the timer
simple, but that the questions are formatted in a simple, keeps going even when you’re taking a restroom break.
straightforward style that is not meant to trick or confuse ■ Don’t allow yourself to become frustrated. If you feel
you. However, the exam is meant to measure and evalu- anxiety creeping in, take a minute to look away from the
ate your knowledge of the subject. Each question will computer, take a deep breath, clear your mind, then col-
have only one right answer, along with several “distractor” lect yourself and refocus.Tell yourself you can do this.
choices that may look very plausible or even correct at first ■ During the exam, you will be able to access a list of
glance. Distractors are not meant to confuse or trick you, commonly used acronyms used on the DANB exam, so
even though it may appear that way at first. Don’t allow don’t worry that you’ll forget what the letters in OSHA
yourself to become frazzled. Have confidence in your stand for.
knowledge and read each question and answer carefully. ■ Don’t dwell on answers you really don’t know. If you
Familiarize yourself with multiple-choice-style questions truly don’t know the right answer, give it your best edu-
and follow these strategies when answering multiple-choice cated guess and move on. You will not be penalized for
questions: guessing incorrectly (some exams will take off more
■ Read all directions very carefully, even if you think you points for wrong answers than blank ones; the DANB
know what they may say. does not do this).
■ Read the question carefully and look for clues to the ■ If, after eliminating wrong answers and narrowing
right answer: down your answer choices, you are still unsure of the
● Sometimes, the way a question is phrased will offer correct answer, flag the question for review and come
a hint by having only one grammatically correct back to it later. Other questions/answer choices may jog
answer. your memory and give clues to a previous question.
● Dissect the question into smaller parts, if possible, to ■ Only flag for review the questions where you are really
make sure you understand what is being asked. stuck. If you flag too many, you’ll likely end up confus-
■ Look for words that are capitalized or in bold print in ing yourself more.
the question. In negative format questions, the words ■ After you have answered all exam questions within a
“NOT” or “EXCEPT” indicate that the answer will be given component exam, an answer review screen will
negative. The distractors (incorrect answer choices) appear, displaying a comprehensive list of question
will be true. items and indicating which items you’ve left blank (in-
■ Look for absolute words in the answer choices, such as complete) and which items you’ve flagged for review
“always” or “never,” which are rarely the correct answer. or for comment. You may choose to review all items or
■ Have the answer in mind before you begin looking for only review flagged answer choices; however, you must
the correct choice. complete your review in the time you have left.You will
■ Read each answer choice separately and evaluate not receive extra exam time to review the answers.
whether it answers the question completely, is only part ● If you choose to review all questions, only double-

of the right answer, or is completely off topic. check that you’ve marked the answer choices that

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 P R E PA R I N G F O R T H E D E N TA L A S S I S T I N G N AT I O N A L C E R T I F I C AT I O N E X A M 7

you intended. If you find a mismarked item (for ex-

ample, you intended to choose answer “A” but some- After the Exam
how marked “C”), change it.
● If you choose to go back to questions you’ve flagged
You will receive a preliminary score report at the testing
for review, only change the answer if you find a glar- center, and official scores will be mailed to you approxi-
ing error. If you are unsure if the answer is right, do mately 4 weeks after your exam. The scores are “scaled,”
not second-guess yourself. Leave your first answer. meaning that a complex score is translated into a more
Chances are, your first response is right. user-friendly scale. This scale has a numerical range of 100
● After the answer review screen, you will be asked to
(low) to 900 (high). A scaled score of 400 is considered
confirm that you are ending the exam review. After passing for each component. You may retake the compo-
you click “yes,” you will not be able to return to the nent exam(s) that were not passed, but you are required to
exam or change any answers. reapply and pay exam fees for those exams. You must pass
■ You may also flag items for comments. After exit- all component exams within 5 years to receive certification.
ing the answer review screen, the comment review Along with your scaled score, your score report will
screen appears. also show your performance on the subtests or general
● You may choose to comment on all items or only content areas. The performance indicators will show on
those that you have flagged. which sections you scored “high average” (best), “average”
● You are allotted 10 minutes in addition to the exam (medium), and “low average” (weak). If you need to retake
time for posting comments. the test, it is highly recommended that you increase your
● You cannot change answers or return to answer re- knowledge in the “low average” subtest material.
view mode while in comment review mode. For additional information about the DANB exam, such
● After confirming that you are exiting the comment as individualized standards for passing, who else can see
review mode, you cannot return to the exam, to your test scores, how you can request a duplicate score
answer review mode, or to comment review mode. report, etc., visit the DANB website at www.danb.org.

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Dental_CertPrep_Part_I.indd 8 2/12/11 1:39 PM
 p a r t II
Review

GENERAL CHAIRSIDE ASSISTING (GC)

Collecting and Recording Clinical Data

I. Basic Oral and Dental Anatomy and Physiology

A. Bones of the cranium, face, and neck
1. Cranial bones are the single frontal, occipital, sphenoid, and ethmoid bones and also the paired pari-
etal and temporal bones.
2. Facial bones are the lacrimal bones, nasal bones, vomer, nasal conchae, zygomatic bones, maxillae, and
mandible.
3. The hyoid bone is suspended between the mandible and larynx.
B. Muscles of the head and neck
1. Muscles of mastication are: temporal muscles, masseter muscles, internal (or medial) pterygoid mus-
cles, and external (or lateral) pterygoid muscles.
2. Muscles of facial expression are: orbicularis oris muscle, buccinators muscle, mentalis muscle, and
zygomatic major.
3. Muscles of the floor of the mouth are: digastric muscle, mylohyoid muscle, stylohyoid muscle, and
geniohyoid muscle.
4. Muscles of the tongue are classified as intrinsic (within the tongue) or extrinsic (outside the tongue).
Intrinsic muscles shape the tongue during speech, mastication, and swallowing. Extrinsic muscles
move the tongue.
5. Muscles of the soft palate (major) are: palatoglossus and palatopharyngeus.
6. Muscles of the neck are: sternocleidomastoid muscle and trapezius muscle.
C. Glands
1. The most significant glands for dental health professionals are the major and minor salivary glands.
2. The pituitary gland, pineal gland, thyroid gland, and parathyroid glands are found within the head and
neck.
3. The thyroid gland is located within the neck on the front and sides of the trachea just below the larynx.
D. Nerves
1. The trigeminal nerve (cranial nerve V) is the primary source of innervation for the oral cavity.
2. The trigeminal nerve is subdivided into three divisions: maxillary, mandibular, and ophthalmic. Of these
three divisions, the maxillary and mandibular are of particular interest to dental health professionals.
E. Blood vessels
1. Major arteries of the face and mouth are the aorta and the common carotid artery.
2. Blood descends from the face and mouth through this network of veins: maxillary vein, temporal vein,
retromandibular vein, and lingual veins. These veins empty into the jugular veins, which empty into
the superior vena cava to transport blood to the heart and lungs for reoxygenation.

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 10 PA R T I I REVIEW

F. Teeth
1. There are essentially four components of the tooth: enamel, dentin, pulp, and cementum.
2. The tooth consists of a crown and a root.
General Chairside

a. The anatomic crown of the tooth is the part covered by enamel.The clinical crown refers to the
part of the crown visible in the oral cavity.
b. The anatomic root is the part of the tooth covered by cementum.The clinical root refers only to
the part of the root that is not visible.
G. Oral cavity
1. The vestibule is the space between the teeth and the inner lining of the cheeks and lips.
2. The frena (singular: frenum), raised lines of mucosal tissue, are visible when the lips are pulled back
and they support or restrain teeth and other structures.
3. The gingivae—commonly called the gums—are attached to the alveolar ridge and vary in color from
pale pink to brownish pink. Free gingivae or marginal gingivae is where the gingivae meet the
teeth and is the first area to respond to inflammation.
4. The hard palate, a bony plate covered with keratinized tissue, sits toward the front of the mouth and
forms the anterior portion of the palate.
5. The soft palate is composed of muscle tissue rather than bone and sits toward the back of the mouth.
The uvula, the projection visible when the mouth is opened wide, hangs from the back of the soft palate.
II. Clinical Exam
A. While escorting patient to the clinical examination area, observe patient’s overall appearance, gait,
speech, and general behavior and note unusual or concerning characteristics or behavior.
B. Seat patient upright in dental chair, secure paper bib or napkin around patient’s neck, and compile or
update patient’s medical and dental history. Note drug allergies and chronic diseases, such as diabetes;
record the purpose of the patient’s visit.
C. Types and locations of teeth in the primary and permanent dentition
1. Incisors cut food, support lips, and help produce sounds for speech.
2. There are four canine teeth (cuspids), one in each quadrant of the mouth. They have a single cusp
(cingulum), whose primary purpose is to tear food.
3. Premolars are found only in the permanent dentition. They replace the first and second molars of
the primary dentition.
4. First and second molars have four cusps used to chew and grind food.
5. Third molars (“wisdom” teeth) erupt in late adolescence/early adulthood.
D. Surfaces of the tooth are: facial, lingual, incisal/occlusal, mesial, and distal. They are named for their re-
lationship or closeness to other intraoral structures, such as the lips and tongue, or according to which
direction they face within the intraoral cavity.
E. Record abnormal findings in head and neck (TMJ) region
1. As the dentist comments on the patient’s dental conditions and health, note or chart any abnormalities,
such as: soft tissue abnormalities; tooth structure abnormalities, including missing teeth; and restorations.
2. If allowed in your state, examine extraoral soft tissue by palpation. When searching for oral cancer,
examine the head and neck, including inspection and palpation of extraoral tissues, temporoman-
dibular joint, tongue, floor of mouth, palate, uvula, and lymph nodes.
3. Note any other abnormal findings in the head or neck region that may be related to other health
conditions.
III. Patient Charts
A. Identify permanent and primary teeth using numbering systems
1. The universal numbering system is the main numbering system used on dental charts in the United
States.
2. The international tooth numbering system is a two-digit system that uses only numerals 1 through 8
for each digit.
3. The Palmer notation system identifies the teeth by quadrant and number.
B. Chart conditions
1. Use Black’s classification of cavities (describes six classes of cavities and outlines restorative treat-
ments for each) to observe/record suspected cavities.
2. Use abbreviations, symbols, and colors in the patient chart to document decay, restoration, or other
existing conditions.

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 GENERAL CHAIRSIDE ASSISTING (GC) 11

3. Record the results of the periodontal exam, including the dentist’s assessment of mobility, pocket
depth, and furcation involvement.
4. Record existing damage or disease to tooth pulp (endodontics) or periapical tissue.

General Chairside
IV. Diagnostic Testing
A. Assist in collecting diagnostic patient information.
1. Dental radiographs allow the dentist to examine the health of the pulp, the root canal space, and the
bone and to detect possible dental caries.
2. Various pulp tests, such as thermal pulp testing and electric pulp testing, are used to diagnose peri-
odontal disease.
3. Photography can provide a before-and-after record of original conditions and the subsequent effects
of any procedures.
4. Preparing materials for taking an occlusal registration include (1) softening the wax in warm
water and preparing it for placement in the patient’s mouth and (2) mixing other materials on a
paper pad and putting them on a quadrant tray for placement in the patient’s mouth.
B. Diagnostic casts (diagnostic models or study models) are three-dimensional models of the patient’s teeth,
mouth, and arches. They are useful because they show actual distances and proportion of the patient’s
teeth and arches.They are created from alginate impressions and included in the patient’s record.
V. Documenting Treatment
A. Maintain accurate records of drugs prescribed or dispensed to patients. If a drug is discussed in detail
with the patient, record important points of this discussion.
B. Before the patient arrives, familiarize yourself with the patient’s record to alert you to the patient’s pre-
medications (premeds), any medical concerns you and the dental team should be aware of, any change
in dental treatment that should be provided, and any change in the way in which dental treatments
should be performed.
C. Record recommended treatment in patient’s chart and make sure the chart includes signed and dated
consent forms necessary for treatment. If a patient refuses an examination, treatment, or test, document
the refusal in the chart. If possible, ask the patient to sign a statement indicating that they refused treat-
ment and keep that statement in the chart.
D. Record that the patient complied with the treatment provided.
VI. Obtain Vital Signs
A. Take a pulse by gently palpating an artery with fingertips, pressing lightly but firmly enough to feel the
pulse. Count the number of pulse beats for 30 seconds; multiply your count by two and record pulse
rate in patient chart, along with date, time, and your signature.
B. Measure respiration by counting the number of times the patient’s chest rises and falls in 30 seconds.
Each cycle of rise and fall of the chest counts as one. Multiply your count by two and record respiration
rate in patient chart, along with date, time, and your signature.
C. Measure blood pressure using a sphygmomanometer and a stethoscope. Record blood pressure in pa-
tient chart, along with date, time, and your signature. The systolic number is written first, followed by
the diastolic.
D. Temperature is measured with a thermometer at different body sites: under the tongue, inside the arm-
pit, inside the ear, and inside the rectum (for infants). Record temperature in patient chart, along with
date, time, and your signature.

Rev iew Q u esti o n s

1. Using the universal numbering system, the permanent maxillary right second molar is tooth number
A. 2.
B. 7.
C. 15.
D. 18.

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 12 PA R T I I REVIEW

2. A small, rounded extension of bone covered with soft tissue located posterior to the last maxillary molar is the
A. Stensen’s papilla.
B. retromolar pad.
General Chairside

C. maxillary tuberosity.
D. torus palatinus.

3. Which of the following best describes the palantine rugae?

A. The demarcation between the hard and soft palate.
B. Horizontally raised folds of hard tissue behind the incisive papilla on the hard palate.
C. The ridged line that extends from behind the incisive papilla down the midline of the palate.
D. A raised area of tissue just behind the maxillary incisors.

4. To identify Stensen’s papilla, look for a

A. small raised flap of soft tissue on the buccal mucosa opposite the maxillary second molar.
B. triangular area of bone covered with soft tissue behind the last mandibular molar.
C. raised horizontal extension of soft tissue along the occlusal line on the buccal mucosa.
D. raised rounded area of soft tissue directly behind the two maxillary central incisors.

5. Which of the following nerves provides sensory innervation for the teeth and mouth?
A. Trapezius
B. Glossopharyngeal
C. Trigeminal
D. Zygomatic

6. Which of the following major salivary glands is located on the side of the face, behind the ramus, below
and in front of the ear?
A. Buccal
B. Parotid
C. Sublingual
D. Submandibular

See p. 33 for the correct answers and rationales

General Dentistry Chairside Procedures

I. Assisting with the Patient and Equipment

A. Prepare the treatment room by cleaning and disinfecting clinical contact areas; placing infection con-
trol barriers in the area; bringing the patient’s record, radiographs, and lab work to the area; bringing in
a sterile preset tray and other supplies; clearing a pathway for the patient; and positioning the dental
chair.
B. Prepare treatment trays by lining up instruments in the order in which they’ll be used. Place those
instruments to be used first on the left side of the tray and hinged instruments on the right side of the
tray. Also, arrange instruments and material based on their function.
C. Greet the patient in the reception area and invite him or her to the treatment room. Once seated in the
dental chair, position the patient upright, supine, semisupine, or subsupine (Trendelenburg). Position
yourself, the operator, the dental unit, and all instruments and equipment that will be needed during a
procedure so that you and the operator use only class I, II, and III motions.
D. Four-handed dentistry, or team dentistry, is the method of providing dental treatment in which the opera-
tor and assistant work together as a team while both are seated in specific positions near the patient.
1. Maintain the dentist’s fulcrum during instrument transfer. A fulcrum is a hand position in which the
dentist’s fingers are stabilized so the hand can easily pivot and perform work in the oral cavity.
2. Sit across from the dentist and hand instruments across the transfer zone to the dentist as needed.
The transfer zone is the space where instrument transfer occurs during four-handed dentistry, usually
below the patient’s chin and directly over his or her throat and upper chest.

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 GENERAL CHAIRSIDE ASSISTING (GC) 13

3. After the patient has been placed in the proper position, the chair may need to be raised or lowered by
the operator to get a clear vision of the operating field and to allow ergonomic access to the oral cavity.
II. Select and Prepare Trays and Other Dental Equipment

General Chairside
A. Select, prepare, and modify impression trays.
1. Selecting a proper tray from among a supply of stock trays requires that you try several before choos-
ing one that causes the patient as little discomfort as possible.
2. Modify stock trays with utility wax. If a stock tray does not fit a patient’s needs, construct custom
trays, which are specially designed and built to fit a particular patient’s mouth. Several types of materi-
als may be used, which may be self-curing or light-cured acrylic resin, vacuum resin, or a thermoplastic
material.
B. The tray for local anesthetic administration should include aspirating syringe, two carpules of anesthetic,
long and short needles, alcohol sponge, cotton gauze, tongue depressor (optional), needle recapping
device, sharps disposal system, topical anesthetic, and a cotton applicator on a clean cotton gauze.
C. Select and prepare tray setups and equipment.
1. The tray setup for anesthetics varies depending on the type of anesthetic being administered.
a. Topical anesthetics setups require a topical agent, gauze pad, and applicator.
b. Local anesthetics require injection equipment and an anesthetic cartridge.
c. Inhalation anesthesia requires nitrous oxide and oxygen cylinders and related equipment.
d. Intravenous sedation setup requires an antiseptic, small needle, tourniquet, and IV.
2. Permanent restorations require a restorative tray (basic setup, hand-cutting instruments, amalgam
carrier, condensers, burnishers, carvers, composite placement instrument, articulating paper holder),
local anesthetic setup, dental dam setup, high-volume oral evacuator tip, high-speed handpiece, low-
speed handpiece, saliva ejector, burs, cotton pellets and rolls, gauze, dental liners, base, bonding
agents, sealers, permanent restorative material (composite or amalgam), and dental floss.
3. Tray setup for tooth whitening includes basic setup, protective gel or dental dam, tooth whitener
product, resin polishing cup or fluoride prophy paste, and a light or laser source.
4. Crown setups require cotton rolls, bite stick, plastic filling instrument, permanent luting cement,
scaler or explorer, custom fabricated crown, and cementing materials.
5. Bridge setups need cotton rolls, petroleum jelly, alginate impression, self-curing acrylic resin with
spatula and mixing container, finishing diamonds or burs, rubber wheels and cusp for polishing,
polishing paste, and cementing materials.
6. Cotton rolls or gauze, a microbrush, and a desensitizing agent are needed for desensitization.
7. Root canal procedures require a local anesthetic agent setup (optional), dental dam setup, handpiece
(high speed) with burs, handpiece (low speed) with latch attachment, syringe, broaches and Hedstrom/
K-type files of assorted lengths/sizes, rubber instrument stops, lentulo spiral, paper points, gutta-percha
points, spoon excavator, endodontic explorer, endodontic sealer supplies, Glick #1, locking cotton pli-
ers, millimeter ruler, sodium hypochlorite solution, hemostat, and high-volume oral evacuator (HVE) tip.
8. Pupal therapies require local anesthetic agent setup, dental dam setup, low-speed handpiece, round
burs, spoon excavators, sterile cotton pellets, formocresol, zinc oxide eugenol base, final restorative
material, and instruments for placement.
9. The exact composition of the surgical tray setup for extractions, impactions, incisions and drain-
age, prosthetic implants, and suture placement and removal depends on the procedure and opera-
tor, so it’s essential to understand the nature of the surgery and the surgeon’s preferences while
assembling the setup.
10. Partial dentures require a basic tray setup, complete with mouth mirror, explorer, and cotton pliers;
articulating paper and forceps; pressure indicator paste; a low-speed handpiece and acrylic and
finishing burs; three-pronged pliers; and the patient’s partial denture.
11. Full and immediate denture setups require a mouth mirror, explorer, and cotton pliers; HVE and
air-water syringe tips; a hand mirror; articulating forceps and paper; high-speed and low-speed
handpieces and burs and discs; the patient’s dentures from the laboratory; and take-home materials
and hygiene aids.
12. Fluoride treatments require disposable applicator trays, a saliva ejector, air-water syringe, cotton
rolls, and a timer.
13. Initial impressions for partial and full dentures require a basic tray setup and stock trays for alginate
impressions and a wax bite registration.The alginate impressions will be used to make the custom
trays used in the secondary impressions.

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 14 PA R T I I REVIEW

14. Secondary impressions for partial dentures require the basic tray setup, mouth wash, the custom
tray created for the patient or a stock tray, contouring wax and impression materials (spatula and
mixing pad or dispensing gun and tips), a laboratory prescription form, disinfectant, wax or sili-
General Chairside

cone bite registration materials, a container for the impressions and bite registration, and tooth
shade and mold guides.
15. Secondary impression setups for full dentures require a mouth mirror, explorer, and cotton pliers;
HVE and air-water syringe tips; cotton rolls and gauze; mouthwash; the patient’s custom tray; com-
pound wax and a Bunsen burner; laboratory knife; impression materials; laboratory prescription
form; disinfectant; and a container for the impressions and bite registration.
16. Setups for fixed space maintainer appliances require permanent cement, a mouth mirror and
explorer, cotton roll and gauze, HVE and air-water syringe, an appliance from laboratory, and
articulation paper.
17. Occlusal equilibration/adjustment requires a mouth mirror, articulation paper, high-speed and low-
speed handpieces, and burs and discs.
18. Oral examination setups require a mouth mirror, explorer, cotton pliers, periodontal probe, gauze
sponges/squares, dental floss, articulating paper and paper holder, air-water syringe, red and blue
colored pencils, eraser, and a clean, unmarked examination form clipped to the patient chart.
19. Oral prophylaxis tray setup includes a mouth mirror, explorer, cotton gauze and swabs, low-speed
handpiece, rubber cups and brushes, prophy paste, and dental floss.
20. Periodontal procedure setups, such as scaling and polishing, require a mouth mirror, explorer, probe,
scalers and curettes, gauze, dental floss and tape, prophy angle with rubber cups and brushes, and
prophy paste.
21. Surgical periodontal procedure setups, such as gingivectomy, require a mouth mirror, explorer,
cotton pliers, periodontal probe, cotton rolls and gauze sponges, saliva ejector with tips, markers,
periodontal knives, scalpel, blades, burs, scalers and curettes, soft tissue rongeurs, surgical scissors,
hemostat, suture supplies, anesthestic supplies, and periodontal dressing supplies.
22. Surgical dressing placement setups require a mouth mirror, explorer, cotton pliers, gauze sponges,
dressing material, paper pad, tongue depressor, lubricant, and contouring instrument.
23. Surgical dressing removal setups require a mouth mirror, explorer, cotton pliers, spoon excavator,
suture scissors, floss, saliva ejector with various tips, gauze sponges, and tissue.
24. Root planing and curettage setups require the mouth mirror, explorer, probe, scalers, curettes,
gauze, dental floss and tape, prophy angle with rubber cups and brushes, and prophy paste.
25. Dental dams require sheets of pliable, thin latex or latex-free material; frames; napkins; lubricants;
templates and stamps; punch; clamps; forceps; floss; and stabilization cord.
26. Dental sealants require protective eyeware, rubber dam or cotton balls, sealant material, etching
agent gel or liquid, pumice and water, prophy brush, applicator device or syringe, high-volume oral
evacuator, curing light with shield, articulating paper and holder, low-speed dental handpiece with
contra-angle attachment, and round white stone (latch type).
a. Temporary crown setup requires cotton rolls, bite stick, plastic filling instrument, temporary lut-
ing cement, scaler or explorer, and prefabricated crown
b. Temporary restorations require a Tofflemire matrix retainer (for class II), a matrix band system
(for classes II, III, and IV), a wedge (for classes II, III, and IV), intermediate restoration material
setup, condenser, carvers, discoid/cleoid, plastic instrument, carver, Hollenback, cotton pellet,
and articulating paper.
c. The basic setup for dry socket or alveolitis requires a mouth mirror, explorer, cotton pliers, peri-
odontal probe, cotton rolls and gauze sponges, saliva ejector with tips, HVE, scissors, irrigation
solution, warm saline solution, iodoform gauze, and medicated dressing.
d. Rotary instruments
III. Assisting with and Performing Intraoral Procedures
A. Maintain the field of operation.
1. Keep the operating field well lit, free from debris and moisture, and easily accessible. Move obstructing
tissues out of the line of vision with instruments such as tissue retractors.
2. Use an air-water syringe in conjunction with the HVE to remove saliva, blood, and debris from the
oral cavity.
3. Clean the area around the operating field with either limited rinsing or complete oral rinsing.
4. Use cotton rolls, dry angle, or rubber dam to isolate the area.

Dental_CertPrep_Part_IIA_GC.indd 14 2/12/11 1:29 PM

 GENERAL CHAIRSIDE ASSISTING (GC) 15

B. Place and remove cotton rolls with gloved fingers or cotton pliers.
C. Assisting with or polishing the teeth.
1. Begin with the surface of the tooth closest to the cheek (the buccal surface) and proceed from the

General Chairside
right side of the mouth to the left, moving across the mandibular arch.
2. After all of the mandibular teeth are polished, work proceeds from left to right, focusing on the side
of the teeth closest to the tongue.
3. Next, the teeth of the maxillary arch are polished in the same order and manner. Utilizing a low-
speed handpiece and a prophy angle, and the finest grit prophylaxis paste possible, the teeth should
be polished using a light, intermittent pressure for 1 to 2 seconds per tooth.
D. Apply topical fluoride, which is available in gels and foams.
1. Remove all plaque and calculus.
2. Seat the patient upright throughout the procedure with a saliva ejector placed between the arches
to prevent ingestion of fluoride.
3. Select a fluoride tray.
4. After loading the fluoride into the tray, dry the teeth and insert the tray into the patient’s mouth.
5. Instruct the patient to bite down to spread the fluoride throughout the teeth.
6. Set the timer and stay with the patient throughout the treatment.
7. After the timer has ended, remove excess saliva and fluoride from the oral cavity.
E. To perform vitality tests, use palpation, percussion, thermal testing, electric testing, radiography, or
transillumination testing.
F. After surgery, control minor bleeding with cotton or gauze pads.
G. Assist with the placement and removal of temporary cement.
H. After a temporary crown is cemented, remove the extra cement from the edge of the tooth with the
dental explorer. Use floss to remove cement from between teeth.
I. Place dental dams after the dentist administers the anesthetic and remove the dental dam after the
procedure.
1. Make sure the site is free from plaque and debris.
2. Mark the dental dam for the appropriate teeth and punch the keyhole and the holes for individual
teeth. Each hole should be separated by a slight septum that will be eased into the interproximal
space.
3. Select a clamp and tie a safety line of dental floss to the clamp bow. Grip the clamp with the forceps,
spread the beaks of the forceps, and use the sliding bar to hold them open. Place the clamp by
sliding it over the anchor tooth. Gently release the forceps and remove the beaks from the anchor
holes.
4. If you haven’t already placed the dental dam, slide the keyhole over the clamp’s bow. Retrieve the
dental floss ligature with cotton pliers or an explorer and slide it through the dental dam. Secure the
dental dam to the opposite tooth.
5. Place the dental napkin around the patient’s oral cavity and slide the frame into position. Hook the
dental dam material on the frame to hold it steady.
6. Work the remaining teeth to be isolated through the punched holes in the dental dam material.
7. Work the dental dam septum in between the tooth contacts, using floss if necessary to ensure that
the dental dam is located below the contacts.
8. Remove the dental dam when indicated. To remove the dental dam, first remove the clamp and any
ligature or stabilization cord used to secure the dental dam. Pull the dental dam away from the teeth.
Clip the interseptal dam bridges.Then remove the dam and frame in one motion. Inspect the dental
dam to make sure no part was left inside the patient’s mouth.
J. Prepare, assist with, and/or apply a matrix band and remove the matrix band after the procedure.
1. Select the band and contour it to make sure it is thinned and slightly concave.
2. Place the band into the retainer handle and insert the retainer into the oral cavity, parallel to the
buccal surface.
3. Slide the open band down over the occlusal surface of the tooth.
4. Adjust the inner knob until the band has tightened around the tooth. Make sure the band is adapted
to the tooth surface and there is no material or tissue between the band and the tooth.
5. Remove the matrix band when indicated.
K. To apply a topical ointment, dry the site with a gauze pad.Then place a small amount of the anesthetic
on the injection site for several minutes.

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 16 PA R T I I REVIEW

L. Assist with and/or monitor the administration of nitrous oxide.

1. Sedation with nitrous oxide begins and ends with giving the patient pure O2.
2. At the start of the process, the clinician establishes the patient’s tidal volume and then slowly titrates
General Chairside

the concentration of N2O until the appropriate level is achieved.

3. At the end of the sedation process, 100% O2 should be given again, for several minutes. Ask the
patient about symptoms such as dizziness, headache, or tiredness. When the patient reports feeling
normal, check vital signs again.
M. Rotary instruments, such as burs and abrasive instruments, can include tips for cutting, grinding,
polishing, and abrading dental surfaces.
1. Burs are available in different shapes (e.g., round, cone, etc.) and in different materials (e.g., diamond,
steel, etc.). Burs are typically identified by their structure and form, as well as their length.
2. Abrasive instruments are most often used to finish restorations, although some can be used for cut-
ting.They lack cutting blades, but instead feature a variety of abrasive materials on a variety of bases
and shapes. Abrasive instruments are classified by their shape (e.g., wheel, disc, etc.) and their mate-
rial (e.g., rubber, stone, etc.).
3. Exchange the rotary instrument in the dental handpiece as needed.
N. Assist with general dentistry and dental emergencies.
1. Anesthesia includes topical and local anesthetics.
a. To apply a topical ointment, dry the site with a gauze pad, place a small amount of the anesthetic
on a cotton-tipped applicator and place it on the injection site, holding it in place for several
minutes before the injection is administered.
b. The dental assistant assembles and passes the syringe to the clinician, receives the syringe after
injection, and recaps using the scoop or one-handed method. The oral cavity is rinsed and the
dental assistant remains with the patient while the local anesthetic takes effect.
2. In cavity preparation and restoration, be familiar with the differences between the various kinds of
restorations, including the instrumentation used in each procedure, the materials required, and the
dentist’s and patient’s needs during the procedure. Your role depends on the specific legal require-
ments and regulations of your state. In states with expanded functions, you may place bases, liners,
and varnishes or create temporary restorations. In states without this function, you will help the
dentist perform these tasks.
3. Assist in crown and bridge restoration preparation, temporization, and cementation.
a. Crowns
1. Before a crown can be placed, the area of the tooth just under the gingival tissue must be ex-
posed with a retraction cord.
2. Prepare the impression material. Load the resin into the prepared impression and transfer the
impression to the dentist, who makes the impression and places the provisional crown.
3. After the provisional crown is removed, assist the dentist in placing the permanent crown by
rinsing and drying the tooth and surrounding it with cotton rolls. Then mix the permanent
cement and transfer it to the dentist, who places the permanent crown.
b. Bridges
1. Place and remove the gingival cord so an accurate impression can be taken, which helps en-
sure the provisional bridge is fabricated to the correct size.
2. To make a provisional bridge, first make an impression of the teeth and arch. Then mix the
resin and place it onto the impression so the dentist can place it in the patient’s oral cavity.
After the resin sets for a few minutes, the dentist removes it from the patient’s mouth. Carefully
remove the provisional coverage from the impression.The dentist then places it back into the
patient’s mouth while it continues to set.
3. The dentist marks and trims off excess material and attaches the provisional bridge with tem-
porary cement.
4. To desensitize teeth, the dental assistant dries the sensitive tooth with a cotton roll or gauze and
hands the desensitizing agent and microbrush to the dentist to apply.
5. The two common endodontic therapies are a root canal and a pulpotomy.
a. For a root canal, aid in preparation by taking a radiograph of the tooth and placing rubber stops
on the endodontic files and reamers for the correct filling of the canal. Isolate the tooth being
treated by assisting with preparation and placement of the dental dam and clean the area to be
treated with disinfectant and a cotton swab.

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 GENERAL CHAIRSIDE ASSISTING (GC) 17

b. For a pulpotomy, prepare and place the dental dam and clean the area to be treated with disinfec-
tant and a cotton swab. After the pulp chamber is exposed by the dentist, transfer a spoon exca-
vator to the dentist for removal of pulp tissue in the coronal chamber.To control hemorrhaging,

General Chairside
transfer to the dentist a sterile cotton pellet moistened with formocresol for placement in the
pulp chamber.
6. Assist with extractions and impactions.
a. For a simple tooth extraction, prepare the patient for surgery and administer a topical anesthetic
and assist in the administration of a local anesthetic. Transfer the elevator and forceps to the
surgeon as he or she performs the extraction. Be ready to remove blood and debris and adjust
the light during the procedure.To assist with tissue retraction, place a pad of gauze in the empty
socket to stop bleeding.
b. In the case of impacted teeth, or complex extractions, first assist the surgeon with anesthesia.
During the operation, transfer instruments to the surgeon and use a special surgical suction tip
to prevent surgical complications. During suturing, place the sutures in the needle holder and
retract the cheeks.
7. Assist with partial and full dentures.
a. In fabricating a partial denture, help with the final impression, wax-denture try-in, and placement
of the denture.
b. In fabricating a full denture, help with the final impression and placement of a full denture.
8. Assist the dentist with occlusal equilibration/adjustment.
9. When assisting with an occlusal registration, have the patient open and close his or her mouth
several times and observe the patient’s normal pattern. Have the patient rinse to remove debris.
Then place the cold wax over the occlusal and incisal surfaces of the teeth. If the wax is long
enough, trim away extra length. Soften the wax and place it against the surfaces of the teeth. Have
the patient bite gently. After the wax hardens, remove it from the patient’s mouth.
10. Carefully observe the oral examination conducted by the dentist. As the dentist comments on the
patient’s dental conditions and health, note or chart the findings on specially designed forms for
the patient’s record.
11. The prophylaxis angle, or prophy angle, is an angled instrument that holds the rubber cup or brush
bristles used for oral prophylaxis. When using the prophy angle and handpiece, the operator alter-
nates between lighter and heavier pressure and applies strokes in a circular motion. Steady pressure
can cause excess heat, which can damage the tooth and cause pain for the patient. The foot pedal
should be released as soon as the prophy angle and handpiece is no longer touching the tooth;
otherwise, it can cause the polishing material to splatter.
12. Periodontal procedures can be either nonsurgical, such as scaling and polishing, or surgical, such
as a gingivectomy.
a. Assist with periodontal procedures by providing retraction of the patient’s lips, tongue, and
cheek and transferring instruments as needed.
b. A dry field is maintained with the high-velocity evacuator to remove excess oral fluids.
c. If periodontal dressing is needed, it is prepared and passed to the dentist.
d. Periodontal dressing removal is accomplished at the postoperative visit.
13. Apply dental sealants.
a. First clean and rinse the teeth.
b. Then isolate the teeth and make sure they are dry. Isolation is usually achieved with a dental dam
or cotton rolls.
c. Apply the etchant to the tooth enamel and remove with suction and rinse the remainder away.
d. Dry the enamel and apply a sealant with a syringe or brush. If necessary, cure the sealant.
e. Check coverage with a mouth mirror.
14. Assist with perioperative treatment and complications.
15. Assist with dental implants and bone grafts.
a. Dental implants may take place in one-stage or two-stage surgeries. Assist with anesthesia,
placement of template over the implants, and transfer the cleaned implant and instruments
to the doctor. Irrigation and evacuation of the surgical field is maintained throughout the
procedure.
b. During a bone graft, help to maintain ease of visibility, rinse the patient’s mouth, transfer instru-
ments as needed for shaping and contouring, and prepare sutures.

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 18 PA R T I I REVIEW

16. Assist with suture placement and removal.

a. To assist in placing sutures, first remove sterile suture material, and using a needle holder, hold
the needle in the upper third, away from the sharp point. Transfer the needle holder to the sur-
General Chairside

geon and provide tissue retraction during placement of the sutures.After the sutures are tied, cut
the sutures with suture scissors.
b. To assist in removing sutures, transfer the cotton pliers to the oral surgeon to lift away the suture
and expose the knot. Transfer suture scissors to surgeon to cut sutures. Retract tissues as neces-
sary. Keep track of the number of sutures removed and compare it to the dental record to make
sure they are all removed.
17. Assist in taking impressions.
a. When assisting with an impression, first prepare the basic tray setup.
b. As the dentist prepares and places the impression material in the tray, prepare materials for tak-
ing the bite registration: softening the wax in warm water and preparing it for placement in the
patient’s mouth.
c. Mix the other materials on a paper pad and put them on a quadrant tray for placement in the
patient’s mouth.
d. After these materials have set, remove them.
e. Disinfect the impressions.
IV. Working with Patients
A. Communicate in a way that conveys professionalism, care, and concern. Focus on office procedures,
policies, and patient care.Try to understand patients’ thoughts and feelings in order to help patients feel
calm and relaxed.
B. Strive to maximize the well-being and health of every patient. This goal can involve extra effort when
patients have special needs, such as physical or intellectual disabilities. Patients who have special needs
may require extra assistance.
C. The best way to prepare for, or prevent, a medical emergency is to be alert and gather as much infor-
mation as possible, including a thorough medical history. Monitor patients who are taking drugs (both
pharmaceutical and illicit drugs) more closely.

Rev iew Q u est i o n s

7. In rubber dam placement, the purpose of inverting the dam is to

A. stabilize the restoration.
B. remove excess material.
C. prevent the clamp from slipping.
D. prevent saliva leakage.

8. Which of the following instruments is likely to be included in a basic tray setup?

A. Chisel
B. Mouth mirror
C. Angle former
D. Amalgam carrier

9. A carious lesion in a pit or a fissure would be classified as:

A. Class I caries: a lesion located in a pit or fissure of a tooth.
B. Class II caries: a lesion located in the interproximal surfaces of a posterior tooth (premolar or molar).
C. Class III caries: a lesion located in the interproximal area of anterior teeth such as canines or
incisors.
D. Class V caries: a lesion located on the cervical area of the tooth.

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 GENERAL CHAIRSIDE ASSISTING (GC) 19

10. Which of the following is an example of biological pulpal stimuli?

A. Changes from hot and cold coming into contact with the tooth
B. Changes in occlusion, resulting in trauma

General Chairside
C. Acidic materials coming into contact with pulpal tissues
D. Bacteria from saliva coming into contact with pulpal tissues

11. What does an etchant remove in preparation for dental bonding?

A. Resin veneer
B. Dentinal tubules
C. Smear layer
D. Pulp

12. Which of the following procedures uses enamel bonding?

A. Sealant
B. Dental varnish
C. Calcium hydroxide
D. Dental base

13. Which instrument is used first during an amalgam restoration?

A. Excavator
B. Cleoid-discoid
C. Burnisher
D. Condenser

14. Which one of the following tests provides a definitive diagnosis of oral cancer?
A. Bleeding upon probing
B. Checking mucosal and gingival pallor
C. Running laboratory blood tests
D. Performing a biopsy

15. Which of the following may help prevent a patient from gagging during an alginate impression?
A. Storing the alginate in a humid environment
B. Using warm water to mix the alginate
C. Mixing the alginate slowly
D. Adding an accelerant to the alginate

16. The curing time of composite restorations depends on the

A. shade of the restorative material.
B. age of the restorative material.
C. etching time.
D. rinsing time.

17. Which of the following must be done first when preparing a tooth for provisional coverage?
A. Placement of gingival retraction cord
B. Preliminary impression
C. Placement of the post and core
D. Removal of tooth structure

18. When assisting during final impressions in a crown and bridge preparation, which elastomeric
impression material is applied first to the teeth?
A. Light-bodied
B. Regular-bodied
C. Heavy-bodied
D. Extra heavy-bodied

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 20 PA R T I I REVIEW

19. What is the operating zone for an assistant who is assisting a right-handed operator?
A. 12 o’clock to 2 o’clock
B. 2 o’clock to 4 o’clock
General Chairside

C. 4 o’clock to 7 o’clock
D. 7 o’clock to 12 o’clock

20. Which part of an anesthetic syringe locks into the rubber stopper so that the stopper can be retracted
by pulling back on the piston rod?
A. Barrel
B. Thumb ring
C. Piston rod
D. Harpoon

21. During a class II amalgam procedure, when is the wedge removed?

A. Before the matrix band and holder are removed
B. After the matrix band and holder are removed
C. Before placement of the amalgam
D. After placement of the amalgam

22. When preparing a Tofflemire matrix band and retainer, the inner nut on the retainer is used to
A. tighten the spindle within the diagonal slot vise.
B. loosen the spindle within the diagonal slot vise.
C. adjust the size of the matrix band loop.
D. hold the wedge in place.

23. Using the clock concept, the zone located between 4 o’clock and 7 o’clock when working with a right-
handed operator is the
A. assistant’s zone.
B. operator’s zone.
C. static zone.
D. transfer zone.

24. When an instrument is held in the palm of the hand with all four fingers surrounding the instrument
and the thumb supporting the instrument, which grasp is being used?
A. Pen
B. Modified pen
C. Palm
D. Palm-thumb

25. When passing an instrument that will be used on tooth number 17, the working end should be in what position?
A. Upward toward the maxillary teeth
B. Downward toward the mandibular teeth
C. Facing to the right
D. Facing to the left

26. Which of the following medications could increase the patient’s blood pressure and heart rate?
A. Aspirin
B. Warfarin
C. Over-the-counter cold medication
D. Nitroglycerin

27. In the United States, nitrous oxide tanks are color-coded

A. green.
B. white.
C. blue.
D. orange.

Dental_CertPrep_Part_IIA_GC.indd 20 2/12/11 1:29 PM

 GENERAL CHAIRSIDE ASSISTING (GC) 21

28. The drug of choice for dental and outpatient inflammatory pain is
A. aspirin.
B. morphine.

General Chairside
C. acetaminophen.
D. ibuprofen.

29. Which drug would be contraindicated in patients with peptic ulcers?

A. Aspirin
B. Acetaminophen
C. Morphine
D. Codeine

30. Nitrous oxide/oxygen inhalation is indicated for which of the following conditions?
A. Adenoid obstruction
B. Dental anxiety
C. Nasal deformity
D. Bronchitis

31. Codeine is classified at what level of abuse and addiction potential?

A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV

32. Why would an oral surgeon administer diazepam (Valium) to a patient before extraction of a molar?
A. To reduce postoperative nausea
B. To relieve anxiety
C. To increase metabolism
D. To control muscle movement

33. What is the most commonly used formulation of topical anesthetic?

A. 20% lidocaine
B. 5% lidocaine
C. 5% benzocaine
D. 20% benzocaine

See p. 33 for the correct answers and rationales

Preparing and Working with Chairside Materials

I. Impressions
A. Prepare various materials for impressions.
1. To mix irreversible hydrocolloid (alginate), measure and place water and alginate powder into the
bowl. Mix with the spatula until smooth. After mixing, fill the impression tray. Alginate impressions
should be poured with model material within 1 hour of being taken to prevent distortion.
2. Reversible hydrocolloid is an impression material that changes physical states upon heating and cooling.
a. A stock water-cooled tray is selected to fit the patient’s mouth without impinging on soft tissues or
teeth.
b. To prevent sticking, plastic stops are placed in the tray.
c. Tubing is connected to the tray and the water outlet to drain.
d. Warm water is pumped through the tubing and tray to liquefy and then moved to a second storage
bath.
e. Light-bodied material is placed in a syringe, heavy-bodied material is placed in the tray, and the tray
is moved to the third tempering bath.

Dental_CertPrep_Part_IIA_GC.indd 21 2/12/11 1:29 PM

 22 PA R T I I REVIEW

f. Light-bodied material is placed around the prepared tooth and the dentist seats the tray.
g. The water running through the tray and tubing is cooled to solidify the impression.
3. Elastomeric materials include polysulfide and silicone. To mix these impressions, dispense equal
General Chairside

lengths of the base and catalyst onto the mixing pad and mix with spatula until the color is uniform.
Load material into impression tray and deliver to the dentist.
4. To prepare bitewing wax, place the cold wax over the occlusal and incisal surfaces of the teeth. If
the wax is long enough, trim away extra length. Soften the wax and place it against the surfaces of
the teeth. Have the patient bite gently. After the wax hardens, remove it from the patient’s mouth.
II. Restorative Materials
A. Prepare various materials for restorations.
1. Amalgam
a. To prepare amalgam, place the mercury and alloy capsule in an activator, if needed, to break the
membrane separating the two materials.
b. Then place the capsule in an amalgamator or triturator to mix the mercury and alloy.
c. After it emerges from the amalgamator, the amalgam is ready to be loaded into the amalgam
carrier, according to the dentist’s preference.
d. Store mercury and amalgam scraps according to local ordinances, or submerged in a covered,
unbreakable container filled with used X-ray fixer.
2. Form dental cement by mixing a powder and liquid, which causes a chemical reaction. Mix cements
on either a glass mixing slab or mixing paper with a spatula, following the manufacturer’s instruc-
tions.The assistant should then load the mixed cement into the prepared crown or bridge.
3. The majority of composites today come in individual cartridges used with a syringe. The assistant
assists with shade selection, loads the appropriate shade cartridge into the syringe, and passes it to
the dentist. The assistant then passes shaping and contouring instruments, clear matrices, and the
curing light if needed.
4. Bonding agents can be self-curing, light-cured, or dual-curing. Some are premixed in applicators,
whereas others require mixing together two liquids. Each system typically includes three basic pro-
cesses: etching, priming, and bonding. Follow the manufacturer’s instructions.Assist with mixing and
passing the components of the bonding system, keeping area clean and dry.
5. Glass ionomers are similar to some composites in their preparation and applications. They can be
supplied as a powder and liquid that must be mixed before application or they are supplied in
premixed application tubes or capsules. Follow the manufacturer’s instructions for mixing and
storage.
6. Intermediate restorative material (IRM) is available as premixed capsules that are triturated like
amalgam or as liquid and powders that must be mixed before application. These materials do not
last more than a year, but this is plenty of time for a provisional restoration.
7. Prepare varnishes, bases, and liners.
a. To prepare varnishes for use, open the bottle of varnish, dip the cotton pellet into the varnish, and
transfer it to the dentist. Recap immediately to prevent thickening of varnish.
b. For bases, mix the cement materials until the consistency of putty and roll into two balls. Use a
plastic filling instrument to pick up each ball and transfer it to the dentist.
c. For liners, dispense equal amounts of each paste onto opposite ends of a paper pad. Use a spatula
to mix the pastes together. Transfer the liner to the dentist. Gather mixed pastes together onto
end of spatula and pass to the dentist.
B. To prepare a provisional crown, prepare the liquid monomer and mix according to the manufacturer’s
directions. Load the resin into the prepared impression and transfer to the dentist.
III. Sedative and Palliative Materials
A. Periodontal surgical dressings can be formulated with or without zinc oxide eugenol. To mix, place
equal lengths of the two pastes on a wax paper pad and mix with a wooden tongue depressor until
uniform in color. When the paste loses its stickiness place it in a paper cup filled with room tempera-
ture water. Lubricate glove hands with water and form into strips and hand to the dentist.
B. Postextraction dressings can be periodontal dressings applied to the extraction sites to protect
the sutures and can be either zinc oxide eugenol or eugenol free. They are mixed like periodontal
dressings.
C. Sedative dressings are specifically formulated with zinc oxide eugenol, which has a sedative or pallia-
tive effect on the tissue.They are mixed the same way as other periodontal dressings.

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 GENERAL CHAIRSIDE ASSISTING (GC) 23

IV. Prepare Other Dental Materials

A. Tooth whitener should be prepared and applied according to the manufacturer’s instructions. Some
products can be applied with a special tray that is custom fitted to the patient’s teeth. Others are

General Chairside
brushed onto the tooth surface. Some materials are light-cured with a special light wand, whereas
others must be continuously washed away and reapplied every 10 minutes during the procedure.
B. Dental assistants use different endodontic materials to assist in root canal therapy. The filling material,
called gutta-percha, is a rubber-like substance. Heat the filling material with a solvent before placing
into the canal space. Gutta-percha is used in combination with an endodontic sealer. Sealers are avail-
able in either paste or powder and liquid form, which should be mixed according to manufacturer’s
instructions and transferred to the dentist.
C. Apply etchants according to the manufacturer’s instructions using the applicator or syringe.
D. Apply sealants according to the manufacturer’s directions. Cure the sealant if necessary, according to
the manufacturer’s instructions.

Rev iew Q u esti o n s

34. Which of the following cements have anticariogenic properties?

A. Zinc polycarboxylate
B. Zinc oxide eugenol
C. Glass ionomer
D. Zinc phosphate

35. Some materials give off heat when mixed.This is called a/an
A. chemical reaction.
B. exothermic reaction.
C. thermal conductivity.
D. thermal expansion.

36. A fluid’s resistance to flow is called its

A. flowability.
B. viscosity.
C. solubility.
D. density.

37. A restoration that is created in the mouth is

A. direct.
B. indirect.
C. preventive.
D. chemical.

38. Dental bonding works by which of the following mechanisms?

A. Creation of a smear layer to aid retention.
B. Dissolution of the smear layer to aid retention.
C. Creation of macromechanical retention.
D. Creation of micromechanical retention.

39. Microleakage occurs when

A. restorations are over-cured.
B. the tooth is over-etched.
C. contaminates are not removed.
D. bonding material is excessive.

Dental_CertPrep_Part_IIA_GC.indd 23 2/12/11 1:29 PM

Other documents randomly have
different content
The Duke of Burgundy, now seven years old, was, in the most
emphatic sense, an enfant terrible. He was very different from his
heavy, stupid father, inheriting some of his qualities, it is said, from
his mother, Mary Anne of Bavaria, a delicate, melancholy,
unattractive princess, passionate, proud, and caustic. Burgundy was
a frail, unhealthy creature, whose body lacked symmetry as well as
his mind. One shoulder very early outgrew the other, defying the
most cruel efforts of the surgeons to set it right, and doing serious
mischief to his general health. His nervous system was much
deranged, so that he was subject to hurricanes of passion. The least
contradiction made him furious. He would fall into 78
ungovernable fits of rage even against inanimate objects. He
had an insatiable appetite for all sorts of pleasure. His pride and
arrogance were indescribable. Mankind he looked upon as atoms
with whom he had nothing in common; his brothers were only
intermediate beings between him and the human race. He had a
quick, penetrating mind, and a marvelous memory. He was stiff
against threats, on his guard against flattery, amenable only to
reason; but by no means always to that. Often when it reasserted
itself, after one of his tornadoes, he was so much ashamed of
himself that he fell into a new fit of rage. He was, however, frank
and truthful in the extreme.

Such was the prince who—with his brothers, the Duke of Anjou,
afterwards Philip V of Spain, and the Duke of Berri—was committed
entirely to the care of Fénelon. When he accepted his new
appointment he abandoned all other offices and occupations,
permitting himself no distractions even of friendship, that he might
concentrate all his powers of insight and reflection upon his charges.
Now, indeed, his studies of education would be fully tested, and on
the most conspicuous conceivable field his theories must be reduced
to practice. It is said that “he pursued only one system, which was
to have none.” In other words, he devoted his fertile mind to
meeting the necessities of the hour as they arose in his volatile,
chameleon-like pupil, instead of subjecting him to a Procrustean
system which could only have had the worst outcome. His facile pen
was employed without stint in the service of his pupil. Many 79
fables, some in French, some in Latin, full of poetry and grace,
were written to convey special lessons to the little duke. “Dialogues
of the Dead” also were composed for the same purpose, bringing in
the principal personages of antiquity to converse on such themes as
would instruct in regard to history and morals. And all this was but a
preparation for “Telemaque,” or Telemachus, composed for the
instruction of the heir to the throne, and endowed with such
unfailing charm by the beauty of its style and the admirable nature
of its sentences, that it has been read ever since in many nations
and by many classes. The same mythology is employed in it that
was used by Homer and Virgil, but refined by the knowledge of the
Divine revelation and adorned by a tincture of Christianity that runs
easily through the whole narrative. The best classical and moral
maxims are placed before the mind of the reader, animated with love
and heightened with action. The author shows that the glory of a
prince is to govern men in such a way as to make them good and
happy; that his authority is never so firmly established as in the love
of his people; that the true riches and prosperity of a State consists
in taking away what ministers to general luxury, and in being content
with innocent and simple pleasures.

But, as may well be supposed, it was not the intellectual 80

means alone—the text-books that were prepared, the treatises
that were written, the pains taken with instruction—which most
awaken our admiration, but rather the good sense shown in the
various special expedients that were employed as from time to time
they were found adapted to the needs of the case. Every effort was
made to relieve study from tedium. Lessons were abandoned
whenever the prince wished to begin a conversation from which he
might derive useful information. There were frequent intervals for
exercise. Learning was turned into a pleasure. The real struggle was
with his fiery temperament, which had been hitherto so badly
mismanaged, and which could only be met by patience and
gentleness with firmness. When one of the evil moods seized him, it
was an understood thing in the household that every one should
relapse into an unwonted silence. Nobody spoke to him if they could
help it; his attendants waited upon him with averted eyes as though
reluctant to witness his degradation through passion. He was treated
with the sort of humiliating compassion which might be shown to a
madman; his books and appliances for study were put aside as
useless to one in such a state, and he was left to his own reflections.
Such a course was the destruction of self-complacency; he ceased to
find relief in swearing when his hearers ceased to be disconcerted by
his abuse, and, being left to consider the situation in solitude, he
saw himself for the first time as others saw him. Gradually this
treatment would bring the passionate but generous child to a 81
better mind, and then, full of remorse and penitence, he
would come to throw himself with the fullest affection and trust
upon the never-failing patience and goodness of the preceptor,
whom he almost worshiped to his dying day.

Fénelon had studied childhood, and knew how deeply rooted is the
child’s fear of ridicule; in the prince it was exaggerated by his
abnormal vanity, and a system which showed him how he degraded
himself, and lost all shadow of dignity when he lost his self-control,
was the surest to produce a radical reform. There are still in
existence two pledges of his childish repentance, testifying to the
difficulty with which his faults were conquered. “I promise, on my
word as a prince to M. l’Abbé de Fénelon, that I will do at once
whatever he bids me, and will obey him instantly in what he forbids;
and if I break my word I will accept any kind of punishment and
disgrace. Given at Versailles, November 29, 1689. Louis.” This
promise, in spite of the word of a prince, was probably broken; for
many months later he enters on another engagement pathetic in its
brevity: “Louis, who promises afresh to keep his promise better. This
20th of September, I beseech M. de Fénelon to take it again.” He
was at this time but eight years old. The child loved his teacher
passionately, and it was seldom that he did not yield speedily to
Fénelon’s wise and loving discipline.
Once, however, there was a serious scene between them 82
which appears to have had a lasting influence upon the prince.
Fénelon had been obliged to reprove him with more than usual
severity, and the boy, in his angry pride, had resisted, exclaiming,
“No, no, sir; I remember who I am, and who you are.” It was
impossible to pass over such a speech and maintain authority; but
acting upon his own maxim, never to administer reproof while either
actor concerned is excited, Fénelon made no reply, and for the
remainder of the day preserved a total silence toward his pupil, who
could not fail to perceive by his manner that the usually indulgent
master was much displeased. Night came with no explanation. But
the next morning, as soon as the prince was awake, the abbé came
into his room, and, addressing him in a grave, ceremonious manner,
very unlike the usual easy tone of their intercourse, said: “I do not
know, Monsieur, whether you remember what you said to me
yesterday, that you knew what you are and what I am; but it is my
duty to teach you your ignorance alike of both. You fancy yourself a
greater personage than I—some of your servants may have told you
so; but since you oblige me to do it I must tell you without
hesitation that I am greater than you. You must see at once that
there can be no question of birth in the matter. It is one of personal
merit. You can have no doubt that I am your superior in
understanding and knowledge; you know nothing but what I 83
have taught you, and that is a mere shadow compared with
what you have yet to learn. As to authority, you have none over me,
whereas I, on the other hand, have full and entire authority over
you, as the king has often told you. Perhaps you imagine that I think
myself fortunate in holding the office I fill about yourself; but there
again you are mistaken. I undertook it only to obey the king, and in
no way for the irksome privilege of being your preceptor. And to
convince you of this truth I am now going to take you to His Majesty
and beg of him to appoint some one else whose care of you will, I
hope, be more successful than mine.” This was no idle threat; for
Fénelon had always been determined to resign the tutorship as soon
as he felt himself to be failing in it; and the prince was obliged to
weigh his pride against his love. His love proved the greater; for life
had been very different with him since Fénelon came into it, and no
sacrifice of his vanity was too galling if he might cancel his offense
and keep his friend. Moreover, he was sensitive to the last degree to
public opinion and the faintest shadow of disgrace. What would the
world think of a prince who was so hopelessly naughty that a man
so universally admired and respected was forced to give him up, and
what would become of the poor little boy to whom his nearest
relatives were, after all, only “His Majesty” and “Monseigneur,” if the
dear, kind preceptor, who loved him and devoted himself so entirely
to him, were to go away? Poor Louis! The storm broke out 84
anew; but this time it was of penitence and shame and regret,
while with passionate sobs and tears he cried out: “O Monsieur, I am
so sorry for what I did yesterday. If you tell the king he will not care
for me any more; and what will people think if you leave me? I
promise, O I promise ever so much, that you shall not have to
complain of me if only you will promise not to go.” But Fénelon
would promise nothing—the lesson would be lost if it were not sharp
—and for a whole day he allowed the duke to undergo the pangs of
anxiety and uncertainty. But at last, when his repentance seemed
unlikely to be soon forgotten, Madame de Maintenon’s intercession
was admitted, and the preceptor consented to remain.

At a much later date Fénelon, writing about these days to a friend,

said of the prince: “He was sincere and ingenuous to a degree that
one only needed to question him in order to know whatever he had
done wrong. One day, when he was very much out of temper, he
tried to conceal some act of disobedience, and I urged him to tell
the truth, remembering that we were in God’s sight. Then he threw
himself into a great passion, and said, ‘Why do you put it in that
way? Well, then, since you ask it so, I can not deny that I did that,’
whatever it was. He was beside himself with anger, but still his sense
of religious duty was so strong that it drew forth the most
humiliating acknowledgments. I never corrected him save 85
where it was really necessary, and then with great caution.
The moment his passion was over he would come back to me, and
confess himself to blame, so that we had to console him; and he
was really grateful to those who corrected him. He used sometimes
to say to me, ‘Now I shall leave the Duke of Burgundy behind the
door, and be only little Louis with you.’ This was when he was nine
years old. Directly he saw me doing any work for him he wanted to
do the same, and would set to on his own account. Except in his
moments of passion I never knew him influenced save by the most
straightforward principles and most strictly in accordance with the
teachings of the Gospel. He was kind and gracious to all who had a
claim upon him; but he reserved his confidence wholly for such as
he believed to be religious people, and they could tell him nothing
about his faults which he did not acknowledge with gratitude. I
never saw any one whom I should less have feared to displease by
telling him the harshest truths concerning himself. I have proved
that by some wonderful experiences.”

It will be somewhat seen, we trust, from all this, how great was the
care and skill expended by Fénelon on his most responsible and
difficult task, and how near an approach he made to imparting a
model education to his pupil. To his religious training, of course, as
well as to that which was more intellectual, the greatest attention
was given. It had a large place in the many conversations held 86
and the many books put into his hands, chief among which
were the Sacred Scriptures. The law of self-denial and self-restraint
was continually inculcated, that one must learn to imitate the Divine
Master if one would fulfill the purpose for which life was given. The
early religious impressions thus imparted were so deeply wrought
that they influenced his whole after life. He was prepared with
greatest care for his first communion, taking it earnestly and
devoutly, and for the rest of his life he was a regular and faithful
communicant, receiving the sacrament with a recollection and
humility of bearing which struck all beholders. A total transformation
was wrought in the royal pupil under the training given, a
transformation which amazed all who were conversant with it. The
Duke de Saint-Simon, speaking of what a prodigy was wrought in a
marvelously short space of time, how the most terrible qualities
were changed into all the opposite virtues, says: “From the beast
which I have described there arose a prince affable, gentle,
moderate, patient, modest, humble, austere but only to himself,
attentive to his duties and sensible of their great extent. His only
object appeared to be to perform all his actual duties as son and
subject, and to qualify himself for his future obligations.” Madame de
Maintenon, in one of her letters, gives the same testimony: “We saw
all those defects which alarmed us so much in the youth of the Duke
of Burgundy gradually disappear. Every year produced in him a 87
visible increase of virtue. So much had his piety changed him
that, from being the most passionate of men, he became mild,
gentle, and complying; persons would have thought that mildness
was his natural disposition, and that he was innately good.” So great
was the alteration in his character and conduct that, had he lived to
ascend the throne, the whole world, as well as France in particular,
would have been immensely the gainer. Hence the limitless devotion
with which Fénelon gave five or six years of his life at the height of
his powers entirely to the royal children and the routine of their
schoolroom duties, was by no means a poor use of his great gifts
and attainments. These years are extremely important, both in his
own history and the history of his country.

One other point deserves mention before we pass from this

interesting period of Fénelon’s life. In entering on his office he laid
down to himself a rule, to which he rigidly adhered, never to ask of
the court a favor for himself, his friends, or his family. The virtue of
this stands out the more when we consider how very rare in those
days was disinterestedness, and that men were none the less
esteemed because they strove to profit themselves and their families
to the utmost in whatever position they filled. It is, then, not a little
remarkable and creditable that Fénelon actually continued in a state
closely approaching destitution; his means were extremely 88
straitened for more than five years after entering upon his
honorable and responsible position at court. His private revenue was
very small, nothing at all coming to him at this time from Carenac,
which he describes as “hopelessly ruined.” No pecuniary income, one
writer says, was attached to his office; but this is hardly credible,
and there are indications that there was a salary, although, strangely
enough, not an adequate one. He kept a very small establishment,
and it was with great difficulty that he found means to meet his
current expenses. Letters to Madame de Laval, a daughter of his
uncle, the marquis, and hence a sister to him, who was his guide
and counselor in money matters, show this. He wrote to her,
October, 1689, concerning the various economies to which he was
subjected, and the sale of his carriage and ponies. Again, in March,
1691, he mentions having repaid one thousand francs out of a debt
of twelve hundred due Madame de Laval, and other sums to other
people. “I have made retrenchments,” he says, “which are very
unusual in my position; but justice comes before all other
considerations. I still owe a considerable sum to my bookseller, and I
must buy some plate to repay you for the things you have loaned
me which are worn out.” He speaks of getting his accounts into
order that he may see his way in his small economies and calculate
how to go on. Again, in January, 1694, he writes concerning a needy
person whom he commends to Madame de Laval, saying: 89
“Although my necessities have never been so pressing as at
present, I beg you to take what is wanted for this man. I am
tolerably well, though very busy; but my purse is at the lowest ebb,
through delays in the payment of my salary, and the exceeding
dearness of everything this year. If I do not receive something
shortly, I must dismiss nearly all my servants. But I will not have you
try to help me. I would rather bear on. All the same, see that any
money that can be sent [from Carenac] reaches me after the more
urgent alms have been disbursed; for indeed I would rather live on
dry bread than let any of the poor of my benefice want.”

This cousin became Fénelon’s sister actually, as well as in name, by

her second marriage with his eldest brother, the Compte de Fénelon;
and probably it never cost him more to refuse anything than when
he refused her request that he would obtain a valuable military post
for her son, a child four years old. But, while eager to do anything
he deemed right to please her, he steadily refused to make the
application she desired. He writes: “I can not relax the strict rule to
which I feel it right in my position to adhere. I would do anything on
earth for you or your son that I can, but not to save my life would I
ask for anything from the king.” Other letters that might be quoted
speak the same language. It was not till 1694 that the king seems to
have remembered or discovered how badly his grandsons’ 90
preceptor was provided for. In that year, at last, he gave
Fénelon the Abbey of St. Valery, which sufficiently filled his purse.
The king informed him of this in person, and apologized for so tardy
an acknowledgment of his gratitude. And the year before, 1693, he
was chosen a member of the French Academy, a high distinction; his
reception speech was made March 31st of that year. It was at this
time, also, that he became a considerable factor in the management
of the celebrated community at St. Cyr, known as the ladies of St.
Louis, who were pledged to a devout and holy life. Madame de
Maintenon had originated the idea of this foundation, with the
special object of educating and training five hundred girls, daughters
of the poorer nobility. It occupied a large share of her thoughts.
Fénelon was associated with Bourdaloue, the Abbé Godet des
Marais, subsequently Bishop of Chartres, and other eminent
ecclesiastics in its government.

It was on February 4, 1695, that the king announced to Abbé de

Fénelon that he had nominated him Archbishop of Cambrai, one of
the richest and most important sees in the kingdom. He was taken
entirely by surprise, but at once replied, after expressing his thanks,
that he could scarcely rejoice in an appointment that would remove
him from the preceptorship to the princes. Whereupon Louis
graciously answered that the abbé was much too useful to be
spared, and that his intention was that he should retain both 91
offices. Fénelon represented that the laws of the Church and
his own conscience made this impossible, as both required residence
in the diocese. But the king bore witness to his appreciation of
Fénelon’s services by overruling this difficulty, and replying, “No, no;
the canons only require nine months’ residence; you will spend three
months with my grandsons, and during the rest of the year you must
superintend their education from Cambrai just as you would at
Versailles.” This point settled, Fénelon went on to say that if he was
indeed to accept the archbishopric he must resign the Abbey of St.
Valery, an act of disinterestedness which Louis altogether refused to
allow. But Fénelon quietly persisted, pointing out to the king that the
revenues of Cambrai were such as to make it an infringement of
canonical law to hold any other preferment with it. Such
conscientious indifference to his own interest excited a great deal of
astonishment and gossip at court. The Bishop of Rheims remarked
that it was all very well for M. de Fénelon, thinking as he did, to act
thus, but that thinking as he did, it was better for him to keep his
revenues. The age was thoroughly accustomed to this plurality of
benefices. In the previous century John of Lorraine was at one and
the same time Archbishop of Lyons, Rheims, and Narbonne, Bishop
of Metz, Toul, Verdun, Theroneune, Lucon, Alby, and Valence, and
Abbot of Gortz, Fecamp, Clugny, and Marmontier. He was also 92
made a cardinal a year or two before attaining his majority.
This was doubtless an extreme case, but there were plenty
somewhat similar. So that Fénelon’s self-denying course meant a
good deal more than it would at the present day.

He was consecrated archbishop June 10, 1695, in the chapel of St.

Cyr, in the presence of a distinguished throng, among whom were
Madame de Maintenon and his three royal pupils. Bossuet was chief
consecrator, the Bishop of Chalons being first assistant, and the
Bishop of Amiens second. Fénelon’s friends were delighted at this
great advancement for him; yet it was felt by many of them that he
should have had the Archbishopric of Paris, for already the popular
voice had widely and loudly nominated him. Some thought that he
was sent to Cambrai by the king for the express purpose of
forestalling this clamor, and avoiding any necessity for putting him in
the more conspicuous and influential place; for it was known that
the post at Paris would soon be vacant, and, if, at its vacancy,
Fénelon had been still unplaced, the pressure for his appointment
there would have been very strong. As it was, M. de Harlai died
August 6, 1695, less than two months after Fénelon’s consecration.
M. de Noailles, Bishop of Chalons, through the influence of Madame
de Maintenon, was given the position.

We have reached now what was, in a worldly point of view, 93

the very summit of Fénelon’s prosperity and glory. It might
seem that, humanly speaking, he had very little, if anything, left to
wish for, although, of course, the cardinalate might fairly have been
expected in a few years. But the clouds were already beginning to
gather which were soon to break over his head in a storm never to
clear away, so far as court favor and the good things of this world
were concerned. So a new chapter must be devoted to these new
experiences which had so very much to do both with his temporal
and spiritual affairs.

94
 CHAPTER IV.
[4]
MYSTICISM AND QUIETISM.

In order that we may properly apprehend the next period in

Fénelon’s life it is absolutely essential for us to take a survey of the
general subject of Mysticism, for with that he became now very
intimately concerned. And, happily, it is a subject of perennial
importance, having no less close connection with the present day
than with the centuries past. Indeed the present age has in some
respects very special need of just this element. It is a commercial,
materialistic, money-grabbing age, devoted to the outward and the
practical; it is a time when the triumphs of machinery and invention
and industrial progress are sounded as never before—an extremely
busy, bustling time of immense external activity, when man hastens
to get rich and rushes through life at railroad speed, scarcely 95
finding leisure so much as to eat, much less for the quiet
contemplation of the things of the spirit. And it is the contemplative,
interior, spirit-filled life with which Mysticism has pre-eminently to
do.

The term, it is true, has come to be widely regarded with suspicion,

and used, more or less vaguely, as a word of reproach. With many,
perhaps with most, it carries an unpleasant, offensive suggestion. Its
associations in their minds are with that which is misty or recondite,
visionary and unintelligible; also with that which is fanatical,
extravagant, unreasonable, and somewhat dangerous. That there is
some ground for this impression can not be denied, because under
the general name of Mysticism much has been included, in the long
sweep of the centuries, which can not be admired or defended;
much which does not commend itself to that level-headed common
sense according to whose dictates we like to think that our religion
can be and should be squared. But we are persuaded that this
extreme objectionable development, or manifestation, of the Mystic
spirit has been much less frequent than is commonly supposed, and
has no sufficient claim to be identified with it in the public mind
anywhere near as largely as it usually is. There is a true Mysticism,
and a false Mysticism. There are Mystics every way worthy of
highest honor, and there are those not at all points deserving
imitation. It surely is a mistake to lay the chief stress on the 96
latter, as is so frequently done, and thus to stamp a stigma
upon all. Christian Mysticism is something of which no one can
afford to be ignorant. The Church which neglects it or despises it,
whether through misapprehension or some less honorable cause, is
certain to be a large loser.

What is Mysticism? As has been pointed out by several, it is

something which from its very nature is hardly susceptible of exact
definition, does not readily lend itself to the most precise forms of
language. It is a phase of thought or feeling which continually
appears in connection with the endeavor of the human mind to
grasp the Divine essence, and to enjoy the blessedness of actual
communion with the Highest. It springs inevitably from intense
desire for intimate fellowship with God, from the hottest possible
pursuit of the highest ideals. It is a sort of name for the realization
of God as transfused throughout the universe, as being immanent in
material things and in mankind alike. The Century Dictionary defines
Mysticism as “any mode of thought or phase of intellectual or
religious life in which reliance is placed upon a spiritual illumination
believed to transcend the ordinary powers of understanding.” The
Standard Dictionary says that Mysticism is “the doctrine and belief
that man may attain to an immediate direct consciousness or
knowledge of God as the real and absolute principle of all truth. The
term is applied to a system of thought and life of which the chief
feature is an extreme development of meditative and intuitive 97
methods as distinguished from the definitive and scholastic.”
Similarly Dr. J. P. Lange, in the Schaff-Herzog Cyclopedia, says:
“Mysticism has been defined as belief in an immediate and
continuous communication between God and the soul which may be
established by certain peculiar religious exercises.... There is a
mystic element in all true religion.” Cousin says: “Mysticism is the
belief that God may be known face to face without anything
intermediate. It is a yielding to the sentiment awakened by the
Infinite, and a summing up of all knowledge and all duty in the
contemplation and love of Him.” Nitzsch, in his “System of Christian
Doctrine,” declares “that the religious man, the man of faith, is, as
such, a Mystic; for he in whose consciousness God does not appear,
certainly does not feel God, nor can he know or honor Him; but he
who only thinks Him, without loving Him and becoming pure in
heart, can not know Him vitally; much less can he behold Him
spiritually who desires to see Him with the outward sense. The inner
life of religion is ever Mysticism.”

This is why in all ages of the Church, when the outward has come to
usurp and absorb attention, when formalism and ceremonialism
have dominated the mind, when scholasticism has gained
ascendency, and especially when a corrupt looseness of morals has
set in to degrade the very ideals of humanity, there have been 98
those who have arisen to make a stand for a purer, more
fervent, more spiritual type of piety. They have met, of course, with
bitter opposition; they have troubled those who did not wish to be
disturbed in their carnal indulgences or worldly conformities, and
they have had various uncomplimentary epithets thrown at them:
such as, Pietists, Quietists, Mystics, Puritans, Quakers, and
Methodists. They have been misrepresented in manifold ways. They
have been persecuted even unto the death. But they have been the
salt of the earth, and the succession has been kept up under one
name or another from the earliest days to the present. They have
not always been endowed with philosophic minds or skilled in the
learning of the schools. They have been keenly conscious of the
difficulty, the impossibility, of completely expressing, in imperfect
human words, the deep things of God revealed to them on the
mounts of vision with which they have been favored. They have
struggled hard with the inadequacy of the only language at their
command, and have been driven to a liberal use of figures of
speech, some of them questionable in point of propriety. They have
had a cramped vocabulary, have made mistakes, have not found
themselves able to translate into intelligible terms all that was in
their minds. To mint the secrets of the interior life into the current
coin of language suited to the comprehension of common souls
requires a skill given to but few. And more especially have 99
their expressions been found unintelligible, or worse, by
adversaries not qualified by any experience to comprehend what it
was all about. For, as St. Paul says (I Cor. ii): “The natural man
receiveth not the things of the Spirit of God; for they are foolishness
unto him, and he can not know them, because they are spiritually
judged. We speak wisdom among the perfect, God’s wisdom in a
mystery, even a wisdom which hath been hidden, which none of the
rulers of this world knoweth. Which things also we speak, not in
words which man’s wisdom teacheth, but which the Spirit teacheth,
interpreting spiritual things to spiritual men.” The adversaries were
also eager in many cases to remove out of the way those who, by
their purity of life and their opposition to priestly claims and gains,
were esteemed dangerous to the peace of the Church. We are
confident that in the main this is a fair interpretation of the course
which events have taken. Not but what some of the Mystics have
really laid themselves open to the complaints of their enemies. They
have been unguarded in their language, have been so carried away
with ecstasy, as some new precious truth has burst upon them, that
they have stated it too strongly; have not supplied the limitations
and modifications and exceptions which would have been well,
which were necessary for a complete rounding out of the statement;
have taken for granted that the other side had been sufficiently
emphasized before, and that their special mission to 100
emphasize the neglected point would be recognized; hence
they have said things which, by strict construction and taken in bald
literalness, were not precisely true. All this can be granted without
casting any serious reflection either on their character or their
doctrines. Their books must be read with caution and discrimination.
To persons not well balanced they might sometimes be a source of
peril. But this admission is in no way incompatible with the assertion
that they have conferred a very great benefit upon mankind, that
their doctrines, on the whole, are sound, and that this generation
could ill afford to overlook the good to be obtained by careful studies
in this direction.

The first Mystics were really St. John and St. Paul; and their words
have full justification in what they derived from their Divine Master.
Who more positively than the great Apostle to the Gentiles,
“according to the wisdom given unto him,” preached a gospel that
was foolishness to some, but which he continually called the wisdom
and the mystery of God; a gospel which proclaims the Divine
indwelling, we in Him and He in us, our bodies the temples of the
Holy Ghost, believers being “in Christ” and “members one of
another?” He was a man caught up into Paradise, and hearing
unspeakable words which it was not lawful or possible for a man to
utter. “I die daily,” he said, “I have been crucified with Christ, and it
is no longer I that live, but Christ liveth in me;” “To me to live 101
is Christ;” “I have learned the secret, I can do all things in
Him;” “I fill up on my part that which is lacking of the afflictions of
Christ;” “Ye died, and your life is hid with Christ in God;” “In Him we
live, and move, and have our being;” “The Spirit Himself beareth
witness with our spirit,”—and many other such like things there be,
left on record from his pen to show clearly that he was a true Mystic.
Still more, perhaps, do the Mystics look to St. John for complete
authorization of their position. His Gospel is the spiritual Gospel, the
charter of Christian Mysticism. It is he who tells us, “God is love,”
“God is light,” “God is Spirit.” The Divine union which he sets before
us is of the closest kind. “Our fellowship is with the Father, and with
His Son Jesus Christ;” “Ye have an anointing from the Holy One, and
ye know all things;” “The anointing which ye received of Him abideth
in you, and ye need not that any teach you;” “Hereby we know that
He abideth in us, by the Spirit which He hath given us;” “He that
believeth on the Son of God hath the witness;” “He that dwelleth in
love dwelleth in God, and God in him,” etc. It is impossible to quote
a tithe of the words in John’s Epistles and Gospel which embody the
fundamental ideas of Mysticism. Especially do we find in the
marvelous words of Jesus reported by John alone, as by the one
peculiarly fitted to formulate them, in the thirteenth to the 102
seventeenth chapters of his Gospel, the seeds and roots of all
which have been drawn forth by subsequent writers on these
profound themes.

Plato has been called “the Father of European Mysticism.” Dr. Inge
says: “Both the great types of Mystics may appeal to him,—those
who try to rise through the visible to the invisible, through nature to
God; and those who look upon this earth as a place of banishment,
upon material things as a veil which hides God’s face from us, and
who bid us seek yonder in the realm of ideas the heart’s true home.
Plato teaches that the highest good is the greatest likeness to God;
that the greatest happiness is the vision of God; that we should seek
holiness, not for the sake of reward, but because it is the health of
the soul, while vice is its disease; that goodness is unity and
harmony, while evil disintegrates; that it is our duty to rise above the
visible and transitory to the invisible and permanent.”

The Church has never lacked during its history for those who have
followed this line of thought and cultivated this kind of experience.
Clement of Alexandria has been called “the Founder of Christian
Mysticism,” a Neoplatonist among the Fathers; followed by Dionysius
the Areopagite, and a lengthy line of successors, large among whom
looms the noble Bernard of Clairvaux, the glory of the twelfth
century. Without tracing out the story in detail it will be enough for
our purpose to refer briefly to those who, in the few centuries before
Fénelon, stood forth most prominently as leaders in this 103
realm of truth, and so prepared the way for him.

In the fourteenth century we find a most remarkable band of devout

believers who called themselves “Friends of God,” to signify that they
had reached that stage of Christian life when Christ, according to His
promise, would call them “no longer servants but friends.” They
were composed of persons from all classes of society, and from all
the religious orders. Most prominent among these were Master
Eckhart—styled “Doctor Ecstaticus”—vicar-general of the Dominican
order, a man of uncommon purity of life and great excellence of
character, one of the profound thinkers of the Middle Ages; Henry
Suso, who has been called “the Minnesinger of Divine Love,” and
who was wont to say, “A man of true self-abandonment must be
unbuilt from the creature, inbuilt with Christ, and overbuilt into the
Godhead” (he was prior of the Dominican convent at Ulm, where he
died in 1365); Nicholas of Basle; and John Tauler. Nicholas was a
layman who wielded a powerful pen and was also a great preacher;
thoroughly devoted to religion from his earliest days. He traveled
much through Germany, propagating his opinions in a quiet,
unostentatious manner, and gradually there grew up around him a
society of Christians composed of men and women likeminded with
himself, who loved to honor him as their spiritual father. It seems to
have been largely his personal influence which held them 104
together, for they fell to pieces after he was burned at the
stake for heresy, near Poitiers, about 1382.

John Tauler—“Doctor Illuminatus”—born at Strasburg, 1290, and

dying there in 1361, was still more distinguished, although indebted
to Nicholas for being led out into the light. This took place when he
was over fifty years of age. Nicholas, coming to Strasburg to hear
the famous preacher, speedily detected his deficiency in spiritual
experience, and the lack of true power attending the Word on this
account. With rare humility, Tauler, a learned theologian, received
this rebuke from the uneducated layman, and so profited by it that
he was able, though not without long struggle, to enter into
complete freedom. Then he preached in a very different manner, and
the first time he opened his mouth in public fourteen persons fell as
if dead under the Word, and nearly thirty others were so deeply
moved that they remained sitting in the churchyard long after the
congregation was dismissed, unwilling to move away. For eighteen
years after this second conversion he made great progress in the
divine life, rising to a place of highest esteem with his brethren, and
being rightly reckoned among the chief of God’s children on earth.

Properly to be counted among these Friends of God can be set down

the unknown author of “Deutsche Theologie,” or “Theologia
Germanica,” which contained so much truth that it had the
distinguished honor of being put upon the Romish Index of 105
prohibited works. Luther ascribed it to Tauler. It is in his style,
and contains his sentiments; but it is now considered more probable
that it originated a little later than his time, and was written by some
other member of the band. It was their usual practice to conceal
their names as much as possible when they wrote, lest a desire for
fame should mingle in their endeavors to be useful. Luther placed it
next to the Bible and St. Augustine as a source of knowledge
concerning God and Christ and man. Baron Bunsen ranks it still
higher. And many others have expressed their supreme indebtedness
to it for help in respect to the perfect life. It has continued up to the
present day to be the favorite handbook of devotion in Germany.

Concerning the views and doctrines of these Friends of God,

although some of their expressions and opinions may be objected to,
considering the corrupt age in which they lived they must be
pronounced worthy of high praise. They insisted, first of all, on the
uttermost self-renunciation, yet they avoided the system of
penances and austerities common in the monasteries. Neither idle
contemplation nor passive asceticism found favor with them; they
were evangelical and practical, full of good works and the imitation
of Christ both in patient suffering and active usefulness. They were
animated by an exalted reformatory spirit which threw them out of
touch with the ecclesiastics around them. Though they did 106
not in all cases fall under the ban of the Church, they may
still be regarded as forerunners of the Reformation. Their Mysticism
was a powerful protest against the terrible corruptions of the Romish
Church and the cold, barren speculations of scholasticism. They
craved and secured direct communion with God, unrestricted by
human interposition; an immediate vision of the Almighty, undimmed
by any separating veil and unchanged by any distorting medium.
The highest form of the Divine life in a man seemed to them to be
perfect resignation to the will of God, and they counted prayer to be
the best means of bringing about this state of resignation. “To pray
for a change in one’s circumstances,” they said, “is to pray that what
God sends may be made subject to us, not that we should submit
ourselves to it; and so tends to produce self-assertion, not self-
renunciation.” Nicholas taught that “when self-renunciation is
complete, the soul of man, having become entirely resigned to the
Divine will, becomes so entirely assimilated to the Divine nature that
it has continually a near fellowship with God; he is always in familiar
intercourse with the Spirit of God, who communicates to him all
Divine knowledge.” “All things to the beloved are of God; all,
therefore, are indifferent.” That religion which sprang from fear of
punishment or hope of reward they counted of little worth, and
considered love to be by far the highest state, the only one truly
[5]
worthy of the Christian. Their union with Deity was not that 107
of pantheism but of passionate love, and great prominence
was given to the will as the mainspring on which all developments of
the higher life depend.

The following quotations from “Theologia Germanica” will convey in

a few words what may be called the root ideas of the book and of
the men whose spirit it so well embodies:

“A true lover of God loveth Him alike in having and in not having, in
sweetness and in bitterness, in good or evil report; for he seeketh
only the honor of God, and not his own, either in spiritual or natural
things. Therefore he standeth alike unshaken in all things.”

“All disobedience is contrary to God, and nothing else. In truth, no

thing is contrary to God; no creature, nor creature’s work, nor
anything that we can name or think of, is contrary to God or
displeasing to Him, but only disobedience and the disobedient man.
108
In short, all that is, is well-pleasing and good in God’s eyes, saving
only the disobedient man.”

“The man who is truly godlike complaineth of nothing but of sin only.
And sin is simply to desire or will anything otherwise than the one
perfect good and the one eternal will, or to wish to have a will of
one’s own.”

“Sin is to will, desire, or love otherwise than God doth. Things do not
thus will, desire, or love: therefore things are not evil; all things are
good.”

“He who is truly a virtuous man would not cease to be so to gain the
whole world; yea, he would rather die a miserable death. To him
virtue is its own reward, and he is content therewith, and would take
no treasure or riches in exchange for it.”

“Union with God is brought to pass in three ways; to wit, by

pureness and singleness of heart, by love, and by the contemplation
of God.”

A still greater name among the Mystic writers, coming a bit later
than those already mentioned, is that of Thomas à Kempis, born
near Cologne, in this same West Germany where the Friends of God
flourished, in 1386, and dying about 1470. His “Imitation of Christ”
stands easily at the head of its class, first in popularity and
usefulness among manuals for devotion. “The epic poem of the inner
life,” it has lent the fragrance of its sanctity to every language of the
civilized world, and has been a prime favorite for nearly five hundred
years with all those who have made largest advancement in 109
holy things. Only a few extracts need be given to show how
closely it is in line with what has already been said, and what
remains to be said, concerning the topic of our chapter:

“When a man is so far advanced in the Christian life as not to seek

consolation from any created thing, then does he first begin
perfectly to enjoy God; his heart is wholly fixed and established in
God who is his All in All.”

“There is no other occasion of perplexity and disquiet but an

unsubdued will and unmortified affections.”

“Self-denial is the test of spiritual perfection, and he that truly denies

himself is arrived at a state of great freedom and safety. It is no
small advantage to suppress desire, even in inconsiderable
gratifications. Restless and inordinate desires are the ground of
every temptation.”

“Abandon all, and thou shalt possess all; relinquish desire, and thou
shalt find rest.”

“No evil is permitted to befall thee but what may be made

productive of a much greater good. Receive all with thankfulness, as
from the hand of God, and esteem it great gain.”

“For all that befalleth me I will thank the Love that prompts the gift,
and reverence the Hand that confers it.”

“O Lord God, holy Father, be Thou blessed now and forever! 110
For whatever Thou willest is done, and all that Thou willest is
good.”

“The righteous should never be moved by whatever befalls him,

knowing that it comes from the hands of God, and is to promote the
important business of our redemption. Without God, nothing is done
upon the face of the earth.”

“Perfection consists in offering up thyself, with thy whole heart, to

the will of God; never seeking thine own will either in small or great
respects; but with an equal mind weighing all events in the balance
of the sanctuary, and receiving both prosperity and adversity with
equal thanksgiving.”
“All is vanity but the love of God and a life devoted to His will.”
[6]
Passing over St. Theresa and St. John of the Cross —particulars
about whom may be found in Vaughan—and denying ourselves,
through limitations of space, all quotations from Rodriguez and
[7]
Scupoli, who flourished in the sixteenth century, and wrote
divinely about Divine things, leaving the world heroic examples of
holiness,—we come to St. Francis of Sales and Molinos, both of
whom had close connection with Fénelon, although in 111
different ways. Francis—born in 1567 and departing to glory
in 1622, who has been called “the noblest, tenderest and most
devoted Mystic of the Catholic Church after the Reformation”—more
than any other, was Fénelon’s teacher in matters pertaining to the
inner life, even as Scupoli had been the teacher of Francis. Fénelon
never wearies of recommending to the correspondents whom he is
instructing in spiritual things the perusal of the works of this
delightful and inspiring writer. He says to one: “You can read nothing
better than St. Francis of Sales. Everything he writes is full of
comfort and love; although his whole tone is that of self-
mortification, it is all deep experience, simple precautions, high
feeling, and the light of grace. You will have made a great step when
you are familiar with such mental food.” Upon another he urges “a
half hour spent in meditative reading of the Gospels in the morning,
and an evening portion of St. Francis de Sales.” To the Elector of
Cologne, when about to receive episcopal consecration, he says,
“Read the Life and Works of St. Francis de Sales.” We do not wonder
at these counsels. The two men, the two Francises, were entirely
congenial, marvelously alike in heart and head, with similar vivacity,
urbanity, and grace of manner, polish of style, profundity of insight
into the soul, and practical knowledge of the world. Both had high
rank in State and Church, strong intellects, intense devotion 112
to God, and ability to express truth in a simple, lucid,
attractive way. They were alike in that the profound piety they
taught was not, as in the previous age, reserved for the cloister, but
was quite compatible with mingling in the world, requiring no great
change of habits, but an entire change of motive. Even the life at
court might be continued and graced with cheerful obedience to the
whole will of God; all the actions of the day could be sanctified by a
perpetual prayer offered up in their midst and by a sincere intention
to please God; the humble every-day virtues were extolled, and no
austerities recommended. Thus religion was made commensurate
with the whole of life, and the saint could join in all that others did,
except sin. No difference can be found in their doctrines, or even
their forms of expression, and it seems like an irony of fate that the
Bishop of Geneva should be canonized in 1665 by the same Church
which condemned, in 1699, the Archbishop of Cambrai. The fictitious
and factitious reasons that led to the latter will be detailed a little
later.

Part of the reason is connected with the history and fate of Miguel
de Molinos, commonly esteemed to be the founder of the Quietists.
He was a Spanish theologian, born of noble parentage near
Saragossa, December 21, 1627. He acquired a great reputation at
Rome and elsewhere for purity of life and vigor of intellect, but
steadily refused all ecclesiastical preferment. In 1675 he published
his “Spiritual Guide,” which in a few years passed through 113
twenty editions in different languages, and was warmly
hailed by people of marked piety in many lands. But it was soon
bitterly attacked, especially by the Jesuits, who quickly perceived
that Molinos’ system tacitly accused the Romish Church of a
departure from the true religion, and that his whole doctrine would
militate against the power of the priesthood and the importance of
ceremonialism. Although he had a vast number of friends, some of
them eminent for learning and piety, and even high in worldly rank,
and though the pontiff himself, Innocent XI, was partial to him, he
was, in 1685, cited before the Inquisition and subjected to close
examination as well as rigid imprisonment. It is said that as many as
twenty thousand letters were found in his house, which, if true,
shows the degree to which the movement he headed had spread,
and the hunger of great multitudes for spiritual food. His trial lasted
two years, and in 1687 sixty-eight propositions, purporting to be
extracted from his book, were condemned, and he was declared to
have taught false and dangerous dogmas contrary to the doctrine of
the Church. He was compelled to pass the remainder of his life in
the dungeons of the Inquisition, where he died, after many years of
close confinement, in which he exhibited the greatest humility and
peace of mind.

The principles of his book have been much misunderstood and

misrepresented. The following statement is believed to be 114
substantially correct. He taught that Christian perfection
consists in the peace of the soul, springing from a complete self-
surrender into the hands of God, in the renouncement of all
external, temporal things, and in the pure love of God free from all
considerations of interest or hope of reward. A soul which desires
the supreme good must renounce all sensual and material things,
silence every impulse, and concentrate itself on God. In a state of
perfect contemplation the soul desires absolutely nothing, not even
its own salvation; it fears nothing, not even hell; the one only feeling
of which it is conscious is utter abandonment to God’s good will and
pleasure; it is indifferent to all else; and nothing which does not
reach the will, where alone virtue resides, can really pollute the soul.
The system was termed Quietism, because it laid so much stress
upon inward quiet, passive contemplation, and silent prayer; also
upon freedom from hope and fear, the great agitators of the human
mind.

It is a very vulgar error to suppose that the Mystics taught

abstention from good works, or outward inactivity; for none were
busier in blessing their fellow-men, as the twenty thousand letters
above mentioned might indicate, as well as the ceaseless endeavors
in this direction put forth by Madame Guyon, Fénelon, and the rest.
Mystics are not impracticable dreamers; they have been in a very
marked degree energetic and influential. Their passivity 115
simply meant a calm yet glad acceptance of all God’s
dispensations. They were also abundantly active in the highest
sense, since the old faculties were transformed and uplifted and no
longer shackled by the cramping chains of sin, but enabled to do far
more for the good of mankind and the glory of God in their happy,
healthy working than they ever had done before. They laid great
stress upon faith, rather than rites or austerities, as a means of
justification and sanctification, a peculiarity which seems at the
bottom of the remark of the Romish ecclesiastic who wrote, under
date of July 10, 1685, “I am informed that a Jesuit named Molinos
has been put into the Inquisition at Rome, accused of wishing to
become chief of a new sect called Quietists, whose principles are
somewhat similar to those of the Puritans in England.” There is
sufficient similarity between the Quietism of the seventeenth century
and the Pietism and Methodism of Germany and England in the
eighteenth century to give us a friendly feeling toward it. That the
former was not so well guarded as the latter; was less directed to
practical ends; was not in control of such cool, sensible minds; ran
very easily into abuses; had stronger pantheistic leanings; was more
open to the objection that it taught a strained, impossible perfection
utterly out of reach of all but the few, and attainable by those few
perhaps only under very favorable conditions,—may be freely
granted. But it does not, and need not, prevent our 116
sympathies going out strongly toward those who, in that
earlier day and amid much difficulty, struck out the high path on
lines not essentially at variance with those who, in easier times of
greater enlightenment, came after them. The Mystics, with all their
extravagances, possessed more of the truth of God than could be
found elsewhere within the wide domains of the Roman Church. The
Reformers recognized this, and sympathized far more deeply with
them than with the schoolmen.

It should be said, also, that the Quietists vehemently repudiated the

constructions put upon their writings by their enemies, and the evil
inferences which were drawn from them. They protested against
what others professed to find there as being no part of their real
belief. It seems to us that they have a perfect right to be heard in
explanation of their tenets, and much allowance must be made for
those endeavoring to find expressions that would convey such
profound and lofty thoughts. Professor George P. Fisher, in his
“History of the Christian Church,” says, “The real ground of hostility
to Quietism was its tendency to lead to the dispensing with auricular
confession and penances and outward rites altogether.”

It will be sufficiently evident from what has been now written that
there is Mysticism and Mysticism; and that that which has the best
right to the name lies very close to the most essential truth of the
best religion, inseparable from it so far as it is to answer the deepest
yearnings of the human heart. If religion is not to be made 117
wholly objective, reduced to a round of external
performances, accounted synonymous with philanthropy and
morality; if its subjective side is to have proper recognition as the
controlling one; if being is to take rank above doing, as we firmly
believe it should,—then we are all Mystics in the true sense of the
word. Since we have to do with “the love of Christ which passeth
knowledge,” and which must be known by some higher faculty than
the understanding; since the new birth is fitly compared by the
Master to the mysterious coming and going of the winds of heaven,
and can not be completely comprehended by the human reason;
since the method of God with the soul of man passes all metes and
bounds of man’s finite mind, and the operations of the Holy Spirit
can not be wholly fathomed by cold intellect,—Mysticism has
extremely close relations with all parts of supernaturalism. It is
grounded in a profounder philosophy than those can offer who
assume to scout and scorn it. We as Methodists, especially, believe
firmly in feeling, and in a first-hand knowledge of God as the
privilege of each genuine believer. We hold fast to experience as
having rights which logic and dogma must respect; we have exalted
life above theory, and the vision divine above dead orthodoxy; we
maintain that there is a God-consciousness, as well as a self-
consciousness and a world-consciousness; and that spiritual facts
can be, and should be, verified in personal experience. We count the
words of Pascal divinely true: “The things of this world must 118
be known in order to be loved; but the things of God must be
loved in order to be known.”
“Mysticism,” says Professor J. E. Latimer, “has ever been a reaction
from formalism and dogmatism in religion. When Christian men have
been relying upon the letter, the Mystic has always exalted the spirit.
When the Church has been content with mere dogmatic statement
and intellectual orthodoxy, a Mystic revival has come to rehabilitate
its spiritual life, and sends new streams of power along its arid
channel.” Do we not greatly need this revival now? We do not
believe there is any special danger to-day from one-sided
subjectivity and morbid introspection. The peril is altogether the
other way. Our great want is a profounder apprehension of the basal
truths of the spiritual life, and their practical translation into
individual experience. The knowledge of God is widespread, but it is
superficial. Piety is very bustling, but it is not deep. The utterances
of the Savior and His apostles are taken at a large discount, and the
mass of believers are easily content with a low condition of
spirituality. Hence the Church is feeble, and fails to impress itself
strongly upon the world. It would be immensely benefited by a large
infusion of the spirit of the true Mystic, who wages the most deadly
war with all carnality; who has a terrible moral intensity; who
renounces absolutely all that dims the radiance or shadows the
image of the Perfect One in the mirror of the soul; who is 119
determined, so far as in him lies, to bridge the gulf that
separates him from his Maker and make the closest possible
approach to God. Of Rabbi Gamaliel, a genuine Mystic, it is reported
that he prayed, “O Lord, grant that I may do Thy will as if it were my
will, and that Thou mayest do my will as if it were Thy will.” Charles
Wesley, another Mystic, is very bold and says,
 “Let all I am in Thee be lost,
Let all I am be God.”

Why should it be thought a thing incredible with any that man may
become a partaker of the Divine nature? If to a small extent, why
not, when all the conditions are favorable, to a very large extent?
Why should not the Church in general, and the Methodist Church in
particular, get a new grip on this much neglected but every way
fruitful truth of the Divine indwelling and the Divine immanence, God
in all and all in God, the universe but the will of God expressed in
forms of time and space, humanity reaching its highest point of
development when it most completely entemples Deity, nature a
symbol of God, God revealed in His works? Just so far as this shall
be accomplished will the Church swing out into a wealthy place, and
march forward to large conquest. Complete surrender will be the
prelude to complete possession, and complete possession will
straightway be turned into complete victory over every foe.

120
 CHAPTER V.
THE GREAT CONFLICT.

We come now to the central period of Fénelon’s career, that wherein

he put forth his greatest mental exertion, fighting, as it were, for his
very life, and for that truth which he held much dearer than life. It is
a period which every sketch of him, however brief, touches upon,
and which we must set forth at some length. The last chapter, on
Mysticism and Quietism, will have prepared us to consider somewhat
sympathetically the career of Madame Guyon, who was so closely
linked with Fénelon during these few years, and who was the chief
exponent of the Quietist or Mystic beliefs at this time in France. She
was born, as Jeanne Marie Bouvier de la Mothe, April 13, 1648, at
Montargis, about fifty miles south of Paris, and wedded before she
was sixteen, by the arrangement of her parents, to a man of thirty-
eight, M. Jacques Guyon, who was very wealthy. She had an
unhappy married life, closed by the death of her husband when she
was twenty-eight. She had five children, two of whom died in
infancy. Suffering was her portion, and religion her consolation,
through all her days. When not yet thirteen she read with eagerness
the Life of Madame Chantal, Kempis’ “Imitation of Christ,” 121
and the works of Francis of Sales, making a vow at this time
to aim at the highest perfection and to do the will of God in
everything. Later, when seventeen, this determination was renewed
with fuller purpose and intelligence; yet it was not till she was
twenty, so limited were her privileges of instruction, that her heart
became thoroughly changed, the pleasures of the world put
definitely aside, and her life devoted entirely to God. Her education,
in a convent, was quite defective, but her natural abilities were very
great. She had remarkable powers of conversation, her intellect was
keen, her ascendency over other minds, even some of the greatest,
in after years was very striking. She learned Latin subsequently, that
she might carry on her studies more profoundly. She prepared
extensive commentaries on the Scriptures, and her writings, in their
collective form, were issued in forty volumes. Afflictions many were
used by the Lord to chasten her spirit and deepen her experience.
She lost her mother and father, lost a dearly beloved son and darling
daughter, lost her beauty by the scourge of smallpox at the age of
twenty-two, lost her dearest friend and religious confidante,
Genevieve Granger, prioress of the Benedictines, in 1673, and then
her husband in 1676.

It was July 22, 1672, that she gave herself to the Lord afresh, with
larger comprehension and consecration, without reservation 122
of purpose or time, in the most solemn manner, signing and
sealing the following covenant: “I henceforth take Jesus Christ to be
mine. I promise to receive Him as a husband to me, and I give
myself to Him, unworthy though I am, to be His spouse. I ask of
Him, in this marriage of spirit with spirit, that I may be of the same
mind with Him—meek, pure, nothing in myself, and united in God’s
will; and, pledged as I am to be His, I accept as a part of my
marriage portion, the temptations and sorrows, the crosses and the
contempts, which fell to Him.” This sacred covenant of the spiritual
marriage with her Redeemer, she carefully renewed and reviewed on
its anniversary. Especially noticeable was the renewal in 1681, for it
took place in Annecy, at the tomb of St. Francis of Sales, who, more
than any other human being, was her master in spiritual things, as
he has been to hundreds of thousands more. When left a widow
with large property interests, she first settled up the affairs of the
extensive estate with much skill, without assistance from any one,
did much in charity for those around her, looked after her children,
and then gradually felt her way to what was to be her life-work in
the world. Her spiritual experience all the while was advancing; she
was sinking more thoroughly out of self into God. July 22, 1680, was
a specially memorable epoch with her, when she began to count the
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