Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968-69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20-yr follow-up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death.