Rampant caries is a sign of gross dietary inadequacy, complete absence of oral hygiene practice or systemic illness. The presence of rampant caries is an indication of the need for comprehensive patient evaluation. Caries activity is most strongly stimulated by the frequency, rather than the quantity of sucrose ingested.[5] The message that excessive and frequent sucrose intake can cause caries should be widely disseminated as a public health measure. Chewing of one slice of sugar-free chewing, after meals, for 5–10 minutes is also recommended to high-risk adolescent population.[6] Evidence of new caries activity in adolescent and adult patients indicates the need for dietary counseling. The goals of dietary counseling should be to identify the sources of sucrose in the diet and reduce the frequency of sucrose ingestion, especially before going to bed.