Pull tooth or fill and use retainer and hope for the best? (teeth, pulled)

[bande1102]

For years I had an issue with my back molar (the last tooth). I kept getting cavities, had at least 3 failed crowns, a root canal, and finally, the tooth fractured and I got an infection and we pulled the tooth. I was told when I removed the tooth that eventually I'd probably lose the tooth above it because it would shift(long explanation). Several dentists have told me this. I've been told I'm lucky that I've kept that tooth as long as I have, although it has been filled several times.

So now several years later, I'm having issues with that top tooth that doesn't have a bottom matching one. It shifted away from the other tooth which makes it extremely hard to clean and I constantly feel like I have food particles stuck between that tooth and the one next to it. Trust me, I have a whole arsenal of cleaning supplies.

The top tooth has already been filled a few times and I don't have a whole lot of tooth left to fill.

Now i have a cavities (gumline) in that tooth and the one next to it, which was always the fear. My dentist has offered 3 options:

1) Get an implant on the bottom. Fill both teeth on the top and know that a crown will probably be needed on the top at some point, possibly an implant. She doesn't have a lot of faith in this because of all the issues I had with the bottom tooth. She advises against that unless I really want to try it.

2) fill both teeth. She can add filling to fill the space between the 2 teeth. However, the tooth will shift away from the other and I risk more cavities again.

3) do #2 and add a custom retainer that I would sleep in. This *should* hold that tooth in place, but she figures that will only buy me a few years before it ultimately shifts again. But she doesn't know.

4) Pull the upper tooth. Because that tooth doesn't have a match on the bottom, I am not using it. She said I wouldn't miss it. I asked if my cheeks would sink in and she doesn't seem to think so.

Basically, she feels that I'm going to lose the one upper tooth and we should be focusing on saving the one next to it.

Uggghhh. What would you do?