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Dental erosion can be caused by recurrent contact with regurgitated gastric acid and there are a number of recognised conditions in which this can occur. A previously undescribed condition, which we have termed the 'voluntary reflux phenomenon', is described, and an illustrative case history given, together with details of several other similar cases. The condition may well be first recognised by the dentist, may have serious psychiatric implications, and has features which can help distinguish it from other causes of gastric acid mediated dental erosion. These features are described and discussed, and some suggestions for initial management in general practice made, should the condition be suspected.

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A case is described of a patient who appeared to belong to the category labelled 'resistant' to local analgesia, in whom use of a 5% lignocaine solution with 1 in 100,000 adrenaline allowed painless routine dental treatment to be carried out. A discussion of the case, and the various other opinions which were considered for management, are presented.