Fragility fracture associated with osteoporosis is an immense burden worldwide. Those are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. Based on a worldwide literature survey, I present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width (MCW) of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. Additionally, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. If incidental findings determined on panoramic radiographs are used for identifying individuals, especially postmenopausal females, at risk of having low skeletal BMD, osteoporosis, and fragility fractures, these may be useful tools to reduce the incidence of the first fracture, resulting in a reduction in the secondary fractures, medical costs, mortality, and morbidity associated with osteoporotic fractures, without incurring additional costs. Several recent studies also show that the diagnostic efficacy of computer assisted diagnosis (CAD) and/or artificial intelligence (AI) in identifying asymptomatic individuals with osteoporosis was acceptable. Since panoramic radiography is rapidly shifting to a digital system, the application of CAD and/or AI to digital panoramic radiographs in osteoporosis screening may proceed in the near future.