This study aimed to assess 11-year longitudinal effects of powered toothbrush on periodontal health, caries and tooth loss in an adult population. Participants of Study of Health in Pomerania (SHIP) cohort with dental examinations and interview data at SHIP-1, SHIP-2 or SHIP-3 examinations were included. Mixed-effects linear regression models were constructed between the exposure (manual versus powered toothbrush) and outcome variables (periodontal status using mean probing depth (PD) and mean clinical attachment loss (CAL), caries status using DMFS and DFS scores, and tooth loss), adjusting for potential baseline covariates. Final baseline (SHIP-1) study sample comprised of 2,819 participants. Powered toothbrush users increased from 18.3% (SHIP-1) to 36.9% (SHIP-3); were younger; had significantly less mean PD [β: -0.09 (95% CI: -0.16; -0.02)] and mean CAL [β: -0.19 (95% CI: -0.32; -0.07)] progressions; and had 17.7% less DMFS progression and 19.5% more teeth retained than the manual toothbrushers. In the long-term, powered toothbrush seems to be effective in reducing mean PD and mean CAL progressions, besides increasing the number of teeth retained. © 2019 The Authors. Journal of Clinical Periodontology Published by John Wiley & Sons Ltd.