Dentigerous cysts are usually easy to treat when small. However, extensive cysts are more difficult to manage requiring cyst enucleation and extraction of associated teeth. We advocate the use of assessment criteria to dictate the treatment modality indicated in each individual case such as cyst size and site, patient age, the dentition involved, and the involvement of vital structures. Cyst enucleation without extraction of the impaction, and decompression are two treatment modalities indicated in growing children and adolescents to salvage the involved dentition.