Abstract The amount of mercury released into saliva from dental amalgam fillings is currently being debated. Mercury enters saliva as vapor, ions and particles of amalgam. The aim of the present study was to determine mercury and silver concentrations in saliva of persons with amalgam fillings. Moreover, it was the aim to investigate whether amalgam particles were present in samples of stimulated saliva in control subjects. In that case, we also wanted to determine the influence of these particles on the mercury concentrations found. Fifty-three patients with a wide range of complaints self- related to their amalgam fillings were examined by the Dental Biomaterials Adverse Reaction Unit of Norway. Among other tests, stimulated saliva was collected from each patient and analyzed for mercury and silver. Mercu- ry and silver correlated with the amount of amalgam present. There was a strong correlation between mercury and silver concentrations. Amalgam particles were found by energy dispersive X-ray analysis. It appears that a considerable part of the mercury and silver were present as amalgam particles. The present study shows that amalgam particles in saliva have to be controlled for when analyzing mercury in saliva from subjects with amalgam fillings. Key words Mercury · Silver · Adverse reactions · Dental materials · Saliva Introduction During the past few decades several reviews have been presented concerning the possible influence of mercury from the amalgam fillings on general health [8, 11, 12]. Mercury from dental amalgam restorations enters saliva as vapor, ions and in particles of amalgam [3, 5]. The amount of mercury released depends on the amount of exposed amalgam and several other factors [7, 8, 10]. Most studies have focused on mercury in blood and urine [1, 2]. Some investigators have presented results for intraoral mercury vapor [3] and mercury in feces [4, 6]. In a debated study from Tübingen, Germany, pub- lished only on the Internet [9], mercury released from amalgam restorations into saliva was measured in about 20,000 persons. The authors claim that there is a correla- tion between mercury concentration in saliva and subjec- tive symptoms. The aim of the present study was to measure the content of mercury and silver in saliva. We wanted to determine whether amalgam particles were present in samples of stimulated whole saliva from control sub- jects and, if this was the case, also determine whether such particles might influence the mercury concentra- tions found. Materials and methods During 1997, 53 patients with self-related complaints to dental amalgam were referred to the Dental Biomaterials Adverse Reaction Unit at the University of Bergen, Nor- way, for examination regarding amalgam-related illness. There were 39 women and 14 men with a median age of 46.5 years. The patients had from 0 to 66 amalgam sur- faces (median 21 surfaces). Three patients were lacking mercury values. The patients chewed paraffin wax for 5 min and the stimulated saliva (0.2–1.7 ml) was collected continu- ously into test-tubes. Each sample was mixed with 2 ml G.B. Lygre ( ✉ ) · N.R. Gjerdet Dental Biomaterials Adverse Reaction Unit, University of Bergen, Årstadveien 17, N-5009 Bergen, Norway e-mail: Gunvor.Lygre@odont.uib.no Tel.: +47 55 586 027 Fax: +47 55 589 862 P.J. Høl · R. Eide · N.R. Gjerdet Department of Odontology, Dental Biomaterials, University of Bergen, Bergen, Norway R. Isrenn Department of Biochemistry and Molecular Biology, University of Bergen, Bergen, Norway Clin Oral Invest (1999) 3:216–218 © Springer-Verlag 1999 SHORT COMMUNICATION G.B. Lygre · P.J. Høl · R. Eide · R. Isrenn N.R. Gjerdet Mercury and silver in saliva from subjects with symptoms self-related to amalgam fillings Received: 5 July 1999 / Accepted: 30 August 1999