AIM The aim of this study was to determine the effectiveness of a water flosser device compared to flossing around implants in several clinical parameters and to investigate patients’ perceptions and experiences of implant maintenance. METHODS This study comprised an initial quantitative study and follow-up qualitative study. Patients were randomly divided in two groups, group 1 (experiment) with water flosser and group 2 (control) with dental floss. At each appointment five clinical parameters were recorded: Full Mouth Plaque Score (FMPS), Quigley-Hein plaque index (QHI), Probing Depth (PD), Bleeding on Probing (BOP) and width of Keratinized Tissue (KT) around implants. Patients were then interviewed to investigate perceptions of implant care and maintenance. RESULTS Twenty-four patients with a total of 76 implants completed at least one follow-up appointment. No statistically significant differences were found for any of the investigated parameters. The qualitative data collected with the interviews were reorganized into main themes: implant versus natural tooth care routines and the ‘impact’ of the study intervention. CONCLUSIONS Based on this study, dental floss and water flosser are equally effective in maintaining peri-implant health. The majority of the patients in water flosser group were in favour of this device and willing to continue using it. Longer term follow-up with a larger sample size could help to demonstrate impact in oral hygiene behaviour and clinical outcomes.