We've worked on a lot of first edition Book of Mormons now, and for the most part they just need a simple clean up or stabilization. Every once in a while we see some with major damage, or make-shift repairs, that actually end up causing more damage.
One of the more recent 1830's we worked on had quite the repair done on it. In an effort to keep the cover and text-block together someone had sewn it together in a stab binding fashion using a shoelace. I'm sure at the time, this seemed like a genius fix to a problem, but over the years, this kind of sewing (stab binding on a Western book) can actually cause a lot of damage to the paper. Stab bindings are designed for Asian paper because the long fibers in these papers withstand the stress well.
We carefully dis-bound the book, repaired the holes left from the stab binding, resewed the text block, and put the original cover back on. We also repaired and cleaned up the cover. Now this gem will last awhile longer without acquiring additional damage from what is holding together.