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What is Pagophagia?

Medically Reviewed by Dan Brennan, MD on June 02, 2021

If you have an intense craving to chew on ice, you might have a condition called pagophagia. This is often caused by a nutrition deficiency. Regularly chewing on ice is damaging to your teeth, and it might signal an underlying health condition.

Read on to find out the causes, symptoms, and treatment options for pagophagia today.

Craving Ice

Pagophagia is an intense craving to chew on ice. You have pagophagia if you find yourself frequently driven to chew on ice cubes, ice chips, or even frost from your freezer.

‌Pagophagia is a type of pica. Pica is the desire to eat non-nutritional items such as dirt or paper. If your craving is for ice, then you have a specific type of pica called pagophagia.

If you occasionally enjoy crunching on leftover ice cubes, such as when you finish a fountain drink, that isn’t pagophagia. Chewing on ice only becomes pagophagia when the drive to chew ice is intense and persistent.

Symptoms of Pagophagia

The main symptom of pagophagia is chewing ice. People with pagophagia chew ice cubes, shaved ice, crushed ice, or frost regularly. 

If you have pagophagia you might also have some of the following symptoms:

The above symptoms aren’t caused by chewing ice, however. These symptoms are tied to anemia, a common underlying cause of pagophagia.

Causes of Pagophagia

Iron deficiency.Iron deficiency or iron deficiency anemia is the most common cause of pagophagia. In one study, 16% of people with iron deficiency anemia reported a strong craving to chew on ice.‌

‌There are good reasons people with iron deficiency anemia want to chew on ice.  Chewing on ice helps people with iron deficiency feel more alert and mentally sharp.

Calcium deficiency. Having low levels of iron is the most common nutritional deficiency associated with pagophagia, but low calcium can also trigger the condition.

Eating disorders. A drive to chew on ice might be due to an eating disorder. This can be because your body wants nutrients that it is lacking. People with eating disorders other than pica might also frequently chew on ice to feel full without ingesting any calories.

Dry mouth. If you have xerostomia, or dry mouth, you might develop a habit of chewing ice to keep moisture in your mouth.

Developmental and mental health issues. Other causes of pagophagia include stress, obsessive-compulsive disorder, and developmental disorders.

Complications of Pagophagia

Dental health problems. Pagophagia can have serious consequences for your dental health. The American Dental Association lists ice as one of the top nine foods that damage your teeth.

Chewing ice can:

  • Damage tooth your enamel making you more likely to get to cavities
  • Damage braces or fillings
  • Crack your teeth
  • Irritate your gums and cause gum recession

Malnutrition. If your craving for ice has pushed other food off your plate, pagophagia can cause malnutrition. The risk of malnutrition increases if your ice chewing habit is primarily caused by an eating disorder.

Anemia complications. Iron deficiency anemia, the most common cause of pagophagia, can lead to serious complications if not treated.

Complications include:

Treatments for Pagophagia

If you have pagophagia, you need to treat the underlying cause.

If your pagophagia is caused by iron deficiency, treatment will depend on the severity of your anemia.

Treatment options include:

‌With proper treatment, you can expect your symptoms to improve quickly.  Even before your hemoglobin levels rise, you will find you have less of a craving for ice. Hemoglobin is the measure of red blood cells that carry oxygen in your body. A low level can show you have an iron deficiency.

If your pagophagia is caused by an eating disorder, stress, or obsessive-compulsive disorder, then cognitive behavior therapy can help.

If your pagophagia is caused by dry mouth, try switching from ice to sugar-free chewing gum. This will be safer for your teeth and will encourage saliva production. Depending on the cause, there are a variety of dry mouth treatments available that can increase saliva production. 

If you can’t stop yourself from chewing on ice as you work to address the cause of your pagophagia, stick to either shaved ice or small and mostly melted pieces. This will do less damage to your teeth than larger chunks or cubes.

If you find yourself chewing on ice throughout the day, your body might be trying to tell you something. Protect your teeth and your health by addressing the cause of your ice cravings.

WebMD Medical Reference

Sources

‌SOURCES:

American Dental Association: “6 Habits That Harm Your Teeth (And How to Break Them),” “Healthy Mouth: Top 9 Foods that Damage Your Teeth,” “Xerostomia (Dry Mouth).”

Cleveland Clinic: “Anemia.”

Journal of Clinical and Diagnostic Research: “Pagophagia – A Common by Rarely Reported Form of Pica.”

Mayo Clinic: “Craving and chewing ice: A sign of anemia,” "Hemoglobin test," “Iron deficiency anemia.”

Medical Hypotheses: “Pagophagia improves neuropsychological processing speed in iron-deficiency anemia.”

National Eating Disorders Association: “Pica.”

Rinsho Ketsueki: “Pagophagia in iron deficiency anemia.”

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