Although clinical periodontal disease parameters indicated more severe periodontal disease in CP compared to RA patients, immunologic evaluation did not reveal consistent results regarding proinflammatory and anti-inflammatory cytokine levels. This might be a result of the use of non-steroidal anti-inflammatory drugs and rheumatoid agents by patients with RA.
Although most patients experienced limited pain during scaling, a significant relationship was found between pain and smoking. Women and patients aged 30 to 40 years are likely to be more anxious during scaling. The question, "How fearful are you of having your teeth cleaned?" may not adequately cover all aspects of anxiety for patients' experience of pain during scaling. Clinicians should determine individual treatment approaches to reduce patients' fear, pain, and anxiety related to scaling.
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