Noncarious, cervical, wedge-shaped, sclerotic lesions are commonly encountered in clinical practice. In such lesions, dentin has been pathologically altered, often resulting in partial or complete obliteration of the dentinal tubules. These lesions are known to respond to etching and bonding differently from normal dentin, leading to complications during clinical treatment. A search of the literature was performed to obtain background information on the most commonly cited etiologic factors, clinical diagnoses, and morphologic and chemical characterizations along with an extensive review of all potential obstacles to bonding the most recent adhesives to such a dentinal substrate. Recent progress in adaptive strategies to render dentin more receptive to resin bonding is emphasized in this article, and the major drawbacks of these strategies are discussed.