Summary Osteoporosis is characterized by an increased risk of bone fractures, affecting especially the forearm, vertebrae and hip. Women are more commonly affected than men because their peak bone density is usually less than that of men at adulthood and declines at the menopause. Early detection of osteoporosis is advisable to prevent the often devastating consequences of hip fracture later in life, though a mass screening programme is not considered cost-effective. Once osteoporotic individuals are identified, drug treatment can be effective in increasing their bone mineral density and reducing fracture rates. Is it possible for dentists to accurately detect early osteoporotic changes on dental radiographs and the affected individuals to be referred to a medical specialist? If the radiographs were taken for other diagnostic purposes, this would increase the cost effectiveness of this regime.