Craving & Eating Ice? Pagophagia Explained

Craving & Eating Ice? Pagophagia Explained

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH🔬 Evidence Based
Craving & Eating Ice? Pagophagia Explained

Pagophagia. That’s when somebody is always craving ice. Sure, it’s odorless and flavorless, but some people still crave it, nonetheless. But could chewing ice do damage to your teeth or actually mean that something is wrong, like a deficiency of some sort?

Pagophagia is the compulsive craving for and consumption of ice, often associated with iron deficiency anemia.

The fact that the term “pagophagia” even exists just goes to show you how many people struggle with craving ice or trying to break a chewing ice habit.  

If you’re always carrying a cup of ice around or instinctively chewing on the ice from your drink, you might have pagophagia and not even realize it. 

What is Pagophagia?

Pagophagia is this distinct urge to chew on ice. While some people consider it just a bad habit to get into, other medical experts report that ice chewing may actually be a rare but common form of pica. Pica is a unique medical condition that causes people to eat non-food items; it’s an eating disorder that’s usually brought on by some type of nutritional deficiency. Some medical experts think it’s more tied to emotional health or obsessive-compulsive disorder (OCD.) So, does that mean you’re experiencing a nutritional deficiency or behavioral health issue if you’re always chewing or craving ice? Not necessarily. But maybe! I know; way to be vague, right?!

Technically speaking, pagophagia isn’t necessarily just eating ice. It can also include wanting to eat frost (including the kind that grows in your freezer) or icy drinks on a consistent basis. 

Even though you’ll rarely hear people use the term pagophagia, it’s fairly common to know of someone who’s always chewing or craving ice. And from a dental perspective, it can cause some major tooth-related issues if you aren’t careful. 

Compulsive Ice Chewing & Craving Ice Cubes

Are you always craving ice? If you’re asking for extra ice so that you can chew it up or only going and filling your cup with ice to begin with, we’ve got a problem. It’s one thing if you’re trying to cool down on a hot summer day, but pagophagia isn’t weather dependent; it’s something that happens all year long.

If you’re literally craving ice, it’s worthwhile to consider the causes of pagophagia to rule out any possible nutritional deficiencies. Being aware is the first step, as constantly chewing on ice can damage teeth and dental work. 

Symptoms of Pagophagia

Besides ice cravings, other symptoms that can accompany someone with clinical pagophagia? Yes! You might not experience all of them, but if you check several off of the list, you might need to see a doctor or cognitive behavioral therapist:

  • Having pale skin
  • Elevated heart rate
  • Chest pain
  • Generalized fatigue
  • Feeling depressed
  • Tongue feeling sore or swollen
  • Shortness of breath
  • Dry skin
  • Cold hands
  • Frequent headaches
  • Dizziness
  • Brittle nails
  • Difficulty concentrating

Many of these symptoms also overlap with medical conditions like anemia, pica, or nutritional deficiencies, among others. So, if you’re trying to break the habit of chewing ice but it just seems out of your control (because the cravings are so strong) there might be a much more deeply-rooted reason why.

In years past, we used to brush off chewing ice as a symptom of a much bigger picture. But today, we know that there’s a strong link between pagophagia and other co-existing conditions that affect the health and quality of life of the patient. So, if your dentist seems to be bugging you about chewing ice being bad for your teeth, the issue is much further reaching than just your smile. 

What Causes Pagophagia?

Sometimes people pick up ice chewing out of convenience. Maybe they’re outside on a hot day and trying to cool down, so they suck on some ice in their drink. You like it, so it turns into your go-to after every outdoor project or hard workout in the gym. Other times, the urge just comes naturally. Their brain says, “I need to chew on some ice ASAP.” Pagophagia doesn’t have one known specific cause, but there are definitely several factors that can play into your wanting to chew on ice. Here are just a few different conditions where people tend to be more likely to want to chew on ice (meaning it’s important to rule them out if you’re chewing ice as we speak.)

1. Iron Deficiency Anemia

People used to say it was an old wives’ tale that you were anemic if you chewed on ice. It turns out that it’s not an old wives’ tale at all! Yes, people who have pagophagia might actually be anemic. That means they have low levels of iron in their blood. Anemia can make your skin pale, cause your hands to feel cold, and even make your gums more likely to bleed whenever you floss. People with iron deficiency anemia are usually told to eat more red meats and leafy green vegetables, as those foods are naturally good sources of iron.

2. Calcium Deficiency 

If you’re not getting enough calcium in your diet or have a disorder that reduces calcium levels in your body, you might experience symptoms like muscle aches, pain, or tingling in your extremities (or even your mouth.) Some people who are calcium deficient also crave ice, which isn’t good since both ice chewing and calcium deficiency together can set you up for some serious dental issues later on down the road. 

Adding calcium to your diet can help, but your body also needs vitamin D to process and absorb the calcium. One way we get vitamin D is from being outside in the sun, and since so many of us spend our entire day indoors, it’s worthwhile to take a walk outside or eat on the patio during your lunch break. 

3. Mental Health Issues 

Chewing on ice doesn’t automatically mean you have a behavioral or mental health condition, but you might, especially if you notice other symptoms of stress, emotional instability, depression, or obsessive-compulsive disorder. Some people use their craving to chew ice as a way to cope with other things going on. But unhealthy coping mechanisms—like chewing on ice—aren’t ideal because there are other side-effects that come with it. If you’ve previously dealt with OCD, anxiety, or other types of mental health struggles, the ice eating might just be an afterthought of how you cope with everything else going on in your life. 

4. Eating Disorders

For someone with pica or a nutritional deficiency because of an eating disorder, there may also be a natural instinct to want to chew on ice. Some people even eat ice because it gives them something to chew on without any added calories to their diet. This is another one of those multi-layer conditions where the ice chewing may be tied more to physical or emotional needs or both at the same time. Rest assured, your dental professional is trained to discreetly help you address the oral side effects of eating disorders in a confidential manner. 

5. Dry Mouth

Chronic xerostomia (dry mouth) can leave your mouth feeling sticky, raw, and more prone to cavities or bad breath. While sipping on water during the day is a great way to add moisture to your mouth, chewing on ice might be counterintuitive since it’s hard on teeth. One compromise might be to suck on ice instead. But other great alternatives are to suck on a sugar-free mint, chew sugar-free gum with xylitol, and use saliva substitutes such as drops or moisturizing toothpaste. Also, as your dentist about adding fluoride to your checkups to help remineralize any weak tooth enamel. 

Coping with Pagophagia

What are some ways to deal with pagophagia, lower the risk of complications from chewing ice, or give up eating ice altogether? Just like other habits, whether it be smoking, biting your nails, or a kid using a pacifier, it can take some time and a lot of trial and error. Here are some tips to help you get started:

  • Switch to soft ice so that it’s less damaging to teeth.
  • Suck on ice instead of chewing on it. 
  • Drink borderline-freezing cold water to crave your urge for icy temperatures in your mouth.
  • Find something to replace it, such as chewing gum, taking a quick walk, or practicing mindfulness.

Complications of Pagophagia

Maybe you’ve never had problems from chewing ice, but that doesn’t mean you won’t. Here are some of the biggest issues that medical and dental professionals see in patients with pagophagia:

Dental health problems—Chewing on rock-hard ice can break weak teeth, fracture dental work, and cause premature enamel wear. It’ll also put a dent in your wallet trying to repair it all!

Malnutrition—Not getting enough nutrients or calories in your diet can lead to major physical side effects of malnutrition, such as eating disorders, a compromised immune system, cognitive delays, and kidney problems. 

Anemia complications—Undiagnosed or untreated anemia can lead to other side effects like longer recovery times, heart and lung issues, severe fatigue, and complications during pregnancy. 

How to Treat Pagophagia

The best treatment for pagophagia will depend on what’s causing it. If you’re chewing ice out of habit whenever you finish your drink, you’ll want to make a conscious effort to stop and put it away before you’re tempted. If you think you’re anemic, try upping the iron in your diet and taking a iron supplement to see if you notice a difference. The same can go for a calcium deficiency, with the help of a little sunlight and vitamin D. 

On the other hand, if you’re pretty sure that you have an eating disorder, high levels of stress or depression, or possibly pica, you’ll want to work with a professional. Both medical specialists, as well as professional counselors or mental health therapists, can help you with the tools you need to succeed. 

Preventing Anemia

There are several ways to prevent anemia. First, it's important to eat a healthy, balanced diet that includes plenty of iron-rich foods like: 

  • Red meat
  • Poultry
  • Fish
  • Leafy greens (think spinach)
  • Beans

Vitamin C can also help your body absorb iron more efficiently, so be sure to include plenty of fruits and vegetables in your diet as well. Additionally, avoiding excessive alcohol consumption and quitting smoking can help prevent anemia. 

If you're at risk for anemia or have been diagnosed with the condition in the past, talk to your doctor about iron supplementation.

Talk With Your Doctor 

Let your medical provider know that you’re craving and chewing ice. They may want to ask a few screening questions or take some bloodwork to check your anemia levels. And if you’re feeling stressed or depressed, that’s helpful information as well. Be sure to share if you’re battling other dietary issues, as your health team can help you take the steps necessary to better your nutritional health and overall wellness. Issues such as eating disorders are always handled in a discrete, confidential manner, so you’ll never have to feel judged or ashamed of the struggles you’re facing. The same goes for talking with a licensed mental health professional about your condition. 

Overcoming Chewing Ice

Chewing ice isn’t good for your teeth. In fact, craving ice could mean that something else, like anemia or pica, is to blame. Even if you haven’t experienced dental or medical problems, don’t ignore the signs that you could have pagophagia. It’s best to address whatever is going on before you experience serious medical, mental, or dental consequences from chewing on ice. Your doctor and dentist can help!

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Last updated onMay 2, 2024Here is our process

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