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A computer program that analyzes routine dental X-rays could offer a simple, cheap way to detect the bone-thinning disease osteoporosis, new research suggests.

Researchers in the Academic Center for Dentistry Amsterdam have created a unique way of identifying patients at risk of osteoporosis by using ordinary dental X-rays. Professor Paul F. van der Stelt and his team developed the largely automated approach to detecting the disease during a three-year, EU-funded collaboration with the Universities of Manchester, Athens, Leuven, and Malmo.

Osteoporosis is a condition that features loss of the normal density of bone and fragile bone. Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks.

Symptoms of osteoporosis are related to the location of the fractures. Fractures of the spine (vertebra) can cause severe “band-like” pain that radiates around from the back to the side of the body. Over the years, repeated spine fractures can cause chronic lower back pain as well as loss of height or curving of the spine, which gives the individual a hunched-back appearance often called a “dowager hump.”

Osteoporosis affects almost 15% of Western women in their fifties, 22% in their sixties, and 38.5% in their seventies. As many as 70% of women over 80 are at risk, and the condition carries a high risk of bone fractures, with over a third of adult women falling victim at least once in their lifetime. Wide-scale screening for the disease is not currently viable, largely due to the cost and scarcity of specialist equipment and staff.

In four clinical centers, 671 women with an average age of 55 years were recruited. To obtain the “gold standard”, the team measured bone thickness at the femur, hip, and spine, using the technique that is common for this kind of expensive examination (Bone Mass Density, BMD). In addition, one panoramic and two intra-oral radiographs were made (dental X-rays).The technique involved an innovative software-based approach to detect osteoporosis using routine dental x-rays, by automatically analyzing specific characteristics of the radiographic trabecular bone pattern. These features include, among others, the thickness, the amount of fragmentation, and the main orientation of the structure of the trabecular bone.

Dental X-rays are pictures of the teeth, bones, and surrounding soft tissues to screen for and help identify problems with the teeth, mouth, and jaw. X-ray pictures can show cavities, hidden dental structures (such as wisdom teeth), and bone loss that cannot be seen during a visual examination. Dental X-rays may also be done as follow-up after dentaltreatments.

X-rays are used widely in dental practice for several reasons. Using the image information from these radiographs to detect patients at risk for osteoporosis involves no extra radiation and almost no extra cost, while undetected osteoporotic patients can incur bone fractures and suffer from other problems, reducing the quality of life.