The first step in treating rampant caries:
Zinc oxide acts as obtundant. It also signiﬁcantly reduces the bacteriological count in oral cavity.
When rampant caries occurs, the ﬁrst step is to initiate treatment of all carious lesions, to stop or at least slow the progression of the disease and to identify the most important causes of the existing condition. If the restorative care is to be performed over several visits in the outpatient setting, gross caries excavation as an initial approach in the control of rampant dental caries has several advantages.  The removal of superﬁcial caries and the ﬁlling of the cavity with a glass ionomer material or zinc oxide-eugenol cement (IRM) will at least temporarily arrest the caries process and prevent its rapid progression to the dental pulp.
Application of topical fluoride to all affected teeth
Restoring all teeth with stainless steel crown
Excavation of softened tooth structure and filling with zinc oxide eugenol
Performing oral prophylaxis and instructions about oral hygiene