Building the Bridge: The Perioskoup Story

The Appointment That Started Everything

It was an ordinary Tuesday afternoon in my practice in Bucharest. I had just finished a periodontal maintenance appointment with a patient I had been treating for three years. Her disease had been well-controlled for the first two years - her pocket depths were stable, her bone levels were holding, her home care was good.

But at this appointment, something had changed. Her gums were inflamed again. The pocket depths had increased. When I asked about her home care, she was honest: she had been going through a difficult period at work, her routine had slipped, and she had stopped using her interdental brushes consistently.

Three months of disease recurrence, undoing two years of careful management.

I sat with her for a few minutes after the appointment, trying to figure out what I could have done differently. I had given her excellent clinical treatment. I had explained her condition thoroughly. I had provided written instructions. And yet, without the right support structure between appointments, the disease had come back.

That evening, I called Eduard.

The Team

I had known Eduard Ciugulea for several years through mutual friends. He had a background in full-stack engineering and had been working on consumer applications for most of his career. When I described the problem - the gap between clinical care and daily life - he immediately understood it not as a dental problem, but as a product problem.

"You're describing a habit formation challenge," he said. "The clinical knowledge exists. The patient motivation exists. What's missing is the infrastructure to connect them."

We brought in Petrica Nancu, an AI specialist with experience in health and wellness applications, a few months later. The three of us spent the first several weeks not building anything - just mapping the problem.

The Problem We Were Actually Solving

The more we mapped it, the more we realised that the problem was not unique to periodontology. It was a fundamental challenge in chronic disease management: the gap between what happens in a clinical setting and what happens in a patient's daily life.

In periodontology specifically, this gap has several dimensions:

The knowledge gap. Patients often leave appointments without a clear understanding of their condition, its severity, or what they need to do about it. Clinical language is not patient language.

The instruction gap. Even when patients understand their condition, the instructions they receive are often too generic to be actionable. "Brush better" is not a useful instruction.

The motivation gap. Chronic disease management requires sustained motivation over months and years. Clinical appointments, spaced months apart, provide insufficient motivational reinforcement.

The feedback gap. Patients have no way of knowing whether their home care is working. Without feedback, it is very difficult to maintain behaviour change.

The communication gap. When patients have questions between appointments, they have no easy way to get answers. And when clinicians want to check on a patient's progress, they have no mechanism to do so without scheduling an additional appointment.

Perioskoup was designed to address all five of these gaps.

What We Built

The first version of Perioskoup was built in three months. It was deliberately simple: a patient-facing app that translated clinical recommendations into a personalised daily programme, with reminders, tracking, and educational content.

The clinician-facing dashboard came later - a tool that allows periodontists and dental hygienists to set up patient programmes, monitor engagement, and send targeted guidance between appointments.

We made several deliberate decisions early on that shaped the product:

The clinician stays in control. Perioskoup does not diagnose. It does not make clinical recommendations independently. Everything in the patient's programme is set by their clinician, based on a real examination. The AI personalises the delivery and timing of those recommendations - it does not generate them.

Privacy by design. Patient health data is among the most sensitive data that exists. We built GDPR requirements into the architecture from day one, not as an afterthought. All data is stored in EU-based servers, encrypted at rest and in transit.

SaMD-safe language. We are acutely aware of the regulatory landscape for software as a medical device. Perioskoup is designed to support clinical care, not to replace it. Every piece of content in the app is reviewed against EU MDR and FDA SaMD guidance.

The EFP Award

In May 2025, we submitted Perioskoup to the EFP Digital Innovation Awards at EuroPerio11 in Vienna. We were selected as one of three prize winners from 20 submissions across 17 national societies.

The award was significant not just as validation, but as an introduction. At EuroPerio11, we met periodontists from across Europe who described the same challenge we had been working to solve. The conversations confirmed that the problem was real, widespread, and urgent.

Where We Are Now

We are currently in private beta with a small group of founding clinics. We are onboarding new practices on a rolling basis, with priority given to periodontology and dental hygiene practices.

The waitlist for patients is open. Founding members will receive priority access, founding pricing, and a direct line to the team.

We are not trying to replace the dentist. We are trying to make every dentist more effective - by extending their reach into the 8,700 hours between annual appointments, and giving patients the support they need to actually follow through.

The bridge between the chair and the home. That's what we're building.

Dr. Anca Laura Constantin is a practising periodontist and co-founder of Perioskoup. She is based in Bucharest, Romania.