Background: Dental pain, anxiety, and fear may result in avoiding dental treatment. In this study, we aimed to evaluate patients' pain perception during scaling and its relationship with dental anxiety. Methods: One hundred thirteen patients (72 women and 41 men; mean age, 35.59 ± 9.28 years) participated. Pain levels after scaling were assessed with a visual analog scale (VAS) and an anxiety questionnaire consisting of seven questions, each with five possible answers. Results: The patients were asked to indicate their pain level on a 100-mm VAS, and the mean VAS score was 19.91 ± 17.76 mm. No age and gender differences with regard to pain perception were found. VAS scores were significantly higher in non-smokers (P<0.001); there was a slightly significant relationship between smoking and pain (0.264; P<0.05). The anxiety score ranged from 7 to 35; the mean anxiety score was 14.00 ± 5.30 (range, 7 to 29). The anxiety score was significantly higher in women (P<0.001). The only question correlated with pain during scaling in men was, "How fearful are you of having your teeth cleaned?" (0.322; P = 0.040). Scores for patients aged 29 to 39 years were significantly higher than scores for those aged 51 to 61 years (P<0.01). Conclusions: 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. [ABSTRACT FROM AUTHOR]