A bone density test is one of the most useful tools for catching bone loss before it becomes a serious problem. Also known as a DEXA scan or DXA scan, this simple imaging test measures how strong and dense your bones are. In this article, we explain how the test works, who should get one, what your results mean, and how Canada’s healthcare system can help you take the next step.
What Is a Bone Density Test?
A bone density test uses low-dose X-rays to measure the amount of calcium and other minerals packed into a segment of bone. The most common type is called dual-energy X-ray absorptiometry, or DEXA. Doctors often shorten this to DXA or DEXA scan.
The test works by sending two low-energy X-ray beams through your bones. The machine measures how much of each beam passes through. Denser bones absorb more of the beam. Weaker bones let more of it through.
This measurement gives your doctor a clear picture of your bone strength. It is the gold standard for diagnosing osteoporosis, a condition where bones become thin and brittle over time. Health Canada recognizes osteoporosis as a major public health concern affecting millions of Canadians.
Why Bone Density Matters for Your Health
Your bones are living tissue. They constantly break down and rebuild throughout your life. However, as you age, your body breaks down bone faster than it can replace it.
When bone loss goes undetected, the first sign is often a fracture. A broken wrist from a minor fall, or a hip fracture from standing up too quickly, can signal that bones have become dangerously weak. These injuries can seriously affect your quality of life and independence.
Osteoporosis affects an estimated 2 million Canadians. Women are at higher risk, especially after menopause. However, men are also affected, and bone loss in men is often overlooked.
Furthermore, certain medications, medical conditions, and lifestyle habits can speed up bone loss at any age. That is why a bone density test is such an important screening tool — it catches the problem early, before a fracture occurs.
Who Should Get a Bone Density Test in Canada?
Age and Risk-Based Guidelines
In Canada, most provincial health plans cover a bone density test when it is ordered for a medically appropriate reason. Your family doctor or specialist will decide if you qualify based on your age, sex, and risk factors.
General Canadian guidelines recommend testing for:
Women aged 65 and older
Men aged 70 and older
Postmenopausal women under 65 with risk factors
Men aged 50 to 69 with risk factors
Anyone who has had a fragility fracture after age 40
People taking medications known to weaken bones, such as corticosteroids
Risk Factors That May Fast-Track Your Test
Some people need a bone density test earlier than the standard age guidelines suggest. Talk to your doctor if any of the following apply to you.
A family history of osteoporosis or hip fractures
Low body weight or a history of eating disorders
Smoking or heavy alcohol use
Conditions such as rheumatoid arthritis, celiac disease, or inflammatory bowel disease
Low levels of calcium or vitamin D in your diet
Early menopause (before age 45)
Long-term use of certain medications, including some anti-seizure drugs and cancer treatments
According to the Mayo Clinic’s guide to bone density testing, your doctor will weigh several factors before recommending the test. Do not hesitate to ask your family doctor about your personal risk level.
How Is a Bone Density Test Done?
Preparing for Your Scan
A bone density test is quick, painless, and non-invasive. You do not need to fast or make major changes to your routine beforehand. However, there are a few simple things to keep in mind.
Avoid taking calcium supplements for at least 24 hours before your scan.
Wear comfortable, loose-fitting clothing without metal zippers or buttons.
Tell your doctor if you have recently had a barium study or nuclear medicine scan, as contrast materials can interfere with results.
If you are pregnant or think you might be, let your doctor know before booking.
What Happens During the Scan
You will lie on a padded table while a mechanical arm passes slowly over your body. The scanner most often measures bone density in your lower spine, hips, and sometimes your forearm. These areas are most likely to fracture if osteoporosis is present.
The entire scan usually takes between 10 and 30 minutes. You stay fully clothed, and nothing touches you. The dose of radiation is very low — far less than a standard chest X-ray.
As a result, the DEXA scan is considered safe for most adults. The low radiation exposure is not considered a health risk for the vast majority of patients.
Understanding Your Bone Density Test Results
The T-Score Explained
Your bone density test results are reported as a T-score. This number compares your bone density to that of a healthy young adult of the same sex.
T-score of -1.0 or above: Normal bone density
T-score between -1.0 and -2.5: Low bone density, called osteopenia
T-score of -2.5 or lower: Osteoporosis
A lower (more negative) T-score means your bones are less dense and more likely to fracture. However, a single number does not tell the whole story. Your doctor will look at your T-score alongside your age, health history, and other risk factors.
The Z-Score and What It Means
Your results may also include a Z-score. This number compares your bone density to others in your age group, sex, and body size. A Z-score below -2.0 is considered below the expected range for your age.
Doctors often use the Z-score for younger adults, children, and premenopausal women. It helps identify whether bone loss may be caused by something other than normal aging, such as a medical condition or medication.
The FRAX Tool
Many Canadian doctors use a tool called FRAX alongside your bone density test results. FRAX calculates your 10-year risk of a major fracture. It takes into account your T-score plus other factors like age, smoking history, and family history.
This gives your doctor a more complete picture of your fracture risk. As a result, it helps them decide whether you need treatment, lifestyle changes, or simply more frequent monitoring.
Treatment and Next Steps After a Bone Density Test
Lifestyle Changes That Support Bone Health
If your results show low bone density, do not panic. There is a lot you can do to slow bone loss and protect yourself from fractures.
Calcium and vitamin D: These are the building blocks of strong bones. Most Canadian adults need 1,000 to 1,200 mg of calcium and 800 to 2,000 IU of vitamin D daily. Talk to your doctor about the right amount for you.
Weight-bearing exercise: Walking, dancing, hiking, and strength training all help maintain bone density. Aim for at least 150 minutes of moderate activity per week, as recommended by Canada’s physical activity guidelines.
Quit smoking: Smoking speeds up bone loss. Quitting at any age makes a real difference.
Limit alcohol: Heavy drinking weakens bones and increases fall risk. Stick to the recommended limits in Canada’s low-risk alcohol drinking guidelines.
Fall prevention: Removing trip hazards at home, improving lighting, and wearing supportive footwear can all reduce your risk of a dangerous fall.
Medications for Osteoporosis
For some people, lifestyle changes alone are not enough. Several medications can help slow bone loss or even rebuild bone density. The most commonly prescribed are bisphosphonates, such as alendronate and risedronate. These drugs reduce the rate at which your body breaks down bone.
Other options include denosumab, raloxifene, and hormone therapy for some postmenopausal women. Your doctor will explain which option suits your specific situation, including any side effects to watch for.
For more detail on treatment options, the Healthline overview of osteoporosis treatments offers a helpful summary in plain language.
When to See a Doctor About a Bone Density Test
You should speak to your family doctor about a bone density test if you are in one of the age groups or risk categories mentioned above. Do not wait for a fracture to prompt the conversation.
If you do not have a family doctor, a walk-in clinic can provide a referral or order the test directly, depending on your province. In most provinces, the test is performed at a hospital imaging centre, a radiology clinic, or a bone health centre.
You should also follow up with your doctor promptly if:
You have had a fracture from a minor fall or bump
You have lost more than 1.5 inches of height over time
You have been on corticosteroids for three months or longer
You have a new diagnosis of a condition linked to bone loss
Always speak with a healthcare provider before making any changes to your diet, supplement routine, or exercise programme based on your bone density results. Your doctor is your best guide for understanding what your results mean for your personal health.
Frequently Asked Questions About Bone Density Tests
How often should I get a bone density test?
How often you need a bone density test depends on your age, risk factors, and previous results. Most doctors recommend repeating the test every one to two years if you are on treatment, or every two to five years if your bone density is normal or only mildly low. Your family doctor will advise the right schedule for you.
Is a bone density test covered by provincial health plans in Canada?
In most Canadian provinces, a bone density test is covered under the provincial health plan when it is ordered for a medically appropriate reason, such as age-related risk or a diagnosed condition. Coverage rules vary by province, so it is a good idea to check with your local health authority or ask your doctor before booking. Some private clinics also offer the test for a fee if you do not meet public coverage criteria.
What is the difference between a DEXA scan and a bone density test?
A DEXA scan and a bone density test are essentially the same thing. DEXA stands for dual-energy X-ray absorptiometry, which is the most common method used to measure bone density. The terms DXA scan, DEXA scan, and bone density test are all used interchangeably by doctors and patients.
Does a bone density test hurt?
No, a bone density test is completely painless. You simply lie on a table while a scanner passes over your body. There are no needles, no injections, and nothing that touches your skin. The whole process usually takes less than 30 minutes from start to finish.
Can a bone density test detect osteoporosis early?
Yes, that is one of the main reasons doctors recommend a bone density test for people at risk. The test can detect low bone density (osteopenia) before it progresses to full osteoporosis. Catching bone loss early gives you and your doctor time to act with lifestyle changes or treatment before a fracture occurs.
Can men get osteoporosis and need a bone density test?
Absolutely. While osteoporosis is more common in women, men can and do develop it. Canadian guidelines recommend a bone density test for men aged 70 and older, and earlier for men with risk factors such as low testosterone, long-term steroid use, or a history of fractures. Bone loss in men is often underdiagnosed, so it is worth raising the topic with your doctor.
Key Takeaways
A bone density test (DEXA or DXA scan) measures how strong and dense your bones are using low-dose X-rays.
It is the standard test for diagnosing osteoporosis and low bone density (osteopenia) in Canada.
Women 65 and older, men 70 and older, and anyone with significant risk factors should discuss testing with their doctor.
The test is painless, quick, and uses very low radiation — no preparation is needed beyond avoiding calcium supplements beforehand.
Results are reported as a T-score. A score of -2.5 or lower indicates osteoporosis.
Treatment may include lifestyle changes, calcium and vitamin D supplementation, and prescription medications.
Most provincial health plans in Canada cover the test when it is medically indicated.
Speak with your family doctor or visit a walk-in clinic to find out if a bone density test is right for you.
