PURPOSE: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. MATERIALS AND METHODS: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. RESULTS: 788 Caucasians (52.4% women, overall mean age: 76years, S.D.±9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3years. Calcaneus PIXI T-values<-1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p<0.001). Older persons with osteoporosis had more severe periodontitis (p<0.01). Periodontitis defined by ≥30% of sites with ≥5mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p<0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value<-2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p<0.001). CONCLUSIONS: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures.