SUMMARY The increase in longevity, reduction in tooth loss, increase in periodontal diseases and coronal and root dental caries with aging are contributing to an increased number of seniors with oral health care needs. Dental caries and periodontal diseases disproportionately affect Alaska Native older adults: they are 3 times more likely to have untreated dental caries and 1.7 times more likely to have periodontal disease than the overall United States population. Prospective studies on the prognosis of these oral disorders are lacking, particularly those deconstructing racial and ethnic differences. The goal of this research project is to understand outcomes of geriatric patients with periodontal diseases and/or dental caries and identify prognostic factors for success in disease control, with a focus on Alaska Native seniors. Our primary aim is to estimate, separately, 36-month success rates for periodontitis and dental caries management for geriatric patients overall, and for Alaska Native/American Indian seniors. Our secondary aims are 1) to ascertain practitioner-, patient-, oral environment- and tooth-level prognostic characteristics associated with 36-month successful disease control strategies; and 2) to describe initial disease diagnosis and management strategies used by practitioners, and associated factors. We will accomplish these aims by conducting a prospective cohort prognosis study within a tribal healthcare organization serving urban and remote rural geographical locations in Southeast Alaska. In this observational study, approximately 600 patients with periodontitis and/or dental caries will be systematically enrolled and followed up for three years. Data on oral health, patient, and provider characteristics as well as diagnosis and disease management strategies will be collected at baseline, and yearly up to 3 years after enrollment. This study is innovative and highly relevant to public health and clinical research because it addresses the lack of rigorous prospective US practice-based geriatric oral health research, and the uncertainty in prognosis and prognostic factors when managing oral disorders in patients suffering the greatest oral health disparities. Through prognosis research, we can gain important knowledge on how to potentially improve clinical decision making for better Alaska Native geriatric oral health.