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The OPTISMILE Podcast 59 – Parafunctional Habits – Ice Chewing

Chapters:

[00:45] What happens when you chew on ice?

Chewing ice seems harmless but it’s extremely hard and can lead to micro-cracks in tooth enamel, fillings popping out, or entire pieces of teeth breaking off.

[03:12] What kind of damage does ice chewing do to your teeth?

It can cause sudden fractures, thermal stress, and long-term sensitivity. Repeated crunching weakens teeth and increases the risk of root canals or complex restorations.

[05:00] Is there a deeper link between ice chewing and health issues?

Yes—constant ice chewing could be a sign of iron-deficiency anaemia or a condition called pica. It may also indicate stress-related behaviours.

[07:10] Can craving ice be a sign of iron deficiency or even pregnancy?

Absolutely. Persistent ice cravings can point to nutritional deficiencies. Once the deficiency is treated, the urge often disappears.

[08:00] Does ice chewing affect crowns, fillings, or veneers differently than natural teeth?

Yes—restorations like crowns and veneers are more vulnerable to cracks or chipping at the margins. Fillings can loosen, leading to decay underneath.

[09:15] Can ice chewing worsen TMJ issues or jaw muscle strain?

Definitely. Chewing ice puts huge stress on the jaw and can aggravate existing TMJ discomfort, causing inflammation, morning stiffness or tension headaches.

[10:30] What are the early signs that ice chewing is harming your teeth?

Sensitivity to hot and cold, visible cracks, chipped edges, or a strange “ping” sensation when biting are all signs of damage beginning to occur.

[12:05] How can people break the habit of chewing ice?

Identify the trigger—boredom, stress, or thirst. Replace with crunchy veggies, slushy drinks, or use stress management techniques. Blood tests can reveal any deficiencies driving the habit.

[14:50] Is crushed or soft ice a safer option?

It’s marginally better, but regular chewing—even on softer ice—can still cause micro-fractures. Let it melt or choose safer snacks like almonds or carrots.

[16:20] What’s your final advice for people who love chewing ice?

Be mindful of what’s driving the habit. Ice chewing can be destructive to your teeth and costly to fix. Identify the root cause and stop before serious damage sets in.

Further Listening & Reading

Explore these key pages and podcast episodes on the OptiSmile website:

Full Transcript

OPTISMILE Podcast 59 Parafunctional Habits Series – Ice Chewing

[00:04]
Eon Engelbrecht – E-Radio-SA
Hello and welcome to Save Your Money, Save Your Teeth, the podcast series now focusing on parafunctional habits. That’s our topic at the moment, and parafunctional habits include the unconscious or stress-related things that we do with our mouth that can wreak havoc on our teeth, jaws, and overall health. We’ve already covered quite a few, including nail-biting as well as cheek and lip biting, and this week, we are talking about ice chewing.

Why crunching on frozen water could be cracking your teeth and costing you thousands. I’ve seen this before, people were chewing on ice, especially in summer, I used to have a neighbour during summer, he would just go to his freezer and grab a couple of ice cubes and then just chew on it for fun, not even flavoured or anything, just normal ice cubes, chewing on it and he seemed to enjoy it as well. I just couldn’t really enjoy it, I don’t know what was so amazing about it.

But let’s ask Dr Clifford Yudelman – OptiSmile what happens when you chew on ice. Dr Clifford Yudelman from OptiSmile, thanks for joining us again, are you well?
I’m well, thank you and yeah, I miss summer, we’re getting into winter I guess now in the Western Area.

Aside from ice chewing which we’re going to talk about now, I just find the sound of someone else crunching on ice one of the most annoying sounds or it’s a terrible habit.
It is, terrible noise. Just from the point of view of just, if you’re going to chew ice, do it in the privacy of your own home or something.

Yeah, it’s quite a crunch. I’ve been in a restaurant where someone’s chewing, you think someone just stood on a cockroach or something, it’s crunch, crunch, crunch. Yeah, it’s like a hectic crunch and you can actually hear how damaging it could be to your teeth depending on the state of your teeth I suppose, but I mean, when you look at it just like that, ice chewing actually seems harmless.

I mean, it’s just water, right? Why is it a big deal?
Yeah, I mean, it’s just water, but once it’s frozen, it’s frozen solid and it’s essentially a crystal block.

It’s surprisingly hard and unforgiving. Your tooth enamel is extremely strong, it isn’t designed to crush such a rigid material repetitively and over time this can create micro cracks, especially if you do it daily. Think of it like a windshield, a little chip in your windshield can gradually spread until you have a full-blown crack and for some people, they might say it’s refreshing and crunchy and they love it.

The repeated impact can lead to big trouble for your teeth and your bank account. Once a piece of tooth snaps off or a filling pops out or probably one of the most common things is for one of the sides of a tooth to break off. I think we did an episode on cracked tooth syndrome or cracked teeth and on inlays and onlays so I can absolutely assure you that you’re headed for a dental appointment at some point.

Don’t say, I’ve done this my whole life and nothing’s ever happened, just you wait, you’ve been warned.
Just you wait, yeah, and can you tell us a bit more about the damage that ice chewing can do? I mean, so it can crack your teeth. What else can it do?

[03:12]
Eon Engelbrecht – E-Radio-SA
What else can it do?

[03:25]
Dr Clifford Yudelman – OptiSmile
Yeah, so definitely ice chewing is one of the main culprits for sudden fractures. Even if it doesn’t cause an immediate break, the constant biting and the cold temperature also causes thermal stress on your enamel.

Imagine you’re eating a hot meal and then you’re chewing on ice and over time, you’ve got these micro cracks which are little cracks, somewhat like we mentioned a little chip in your windshield, but then one day you bite down on a piece of ice, a slightly wrong angle and crack and then you’re booking an emergency dental appointment. It’s also tough on existing restorations like your fillings and your crowns or if you’ve had an inlay, you can break the remaining cusp off the tooth. It can loosen or develop gaps between your fillings and your tooth which can lead to decay and then you might be forced into root canal territory or from a so-called harmless ice cube.

We did an episode, as I mentioned, on cracked-tooth syndrome. You can get a partial crack where every time you put a bit of pressure on the corner of the tooth, like say on a pizza crust, as you release, you get a sharp pain on rebound and that’s a sign that your tooth has a crack in it and it stays sensitive to cold. You might get used to it or stop eating on that side, but even if you don’t see a piece broken off, you can have an internal crack that’s heading towards the nerve.

[05:00]
Eon Engelbrecht – E-Radio-SA
If we go a little bit deeper into this topic, is there a link between ice chewing and some more serious or deeper dental health issues, Dr Clifford Yudelman?

[05:10]
Dr Clifford Yudelman – OptiSmile
Yes, I mean sometimes, yes, it can be. The craving for chewing ice, which actually has a medical name, believe it or not, it’s called phagophagia. Phagophagia means to eat and phago, I guess, is Latin for ice. I hope I’m pronouncing it properly.

I don’t think doctors or dentists would probably have heard of that word before, but it’s a lovely word when you see it spelt out with all the Gs and the Ps and more Gs, phagophagia. It’s often associated with iron-deficiency anaemia or something, or pica, which is a compulsion to eat non-food substances, so pica is another whole story. It’s a type of eating disorder, but if people are eating things like ice or sand or literally chewing on pencils and eating the wood, we spoke about nail biting and cheek biting.

It’s somewhat related to an extent, but ice in particular, they’ve shown is if you find yourself constantly craving ice beyond normal hydration or comfort, it’s worth checking with a doctor for possible iron or mineral deficiencies. There’s a lot of vegetarians these days and people that don’t eat enough red meat or don’t eat red meat and they don’t get their iron checked. Iron-deficiency anaemia is not a joke.

You can get iron supplements. My wife is vegetarian. She takes iron supplements daily.

Having said that, she’s not an ice chewer, but yeah, look, it’s commonly associated with iron-deficiency anaemia. Also, it can be a stress response, much like nail biting. If someone’s anxious or bored, they might absentmindedly just chew on ice.

[07:10]
Eon Engelbrecht – E-Radio-SA
I mean, I generally, when I’m around people that are chewing on ice, they tend to be those highly-strung Type-A personalities with a bit of a short temper and then they’re chewing on the ice. It’s kind of aggressive, you don’t get someone who’s chilled, excuse the pun, chewing on ice.

[07:51]
Dr Clifford Yudelman – OptiSmile
Brilliant.

[07:54]
Eon Engelbrecht – E-Radio-SA
That was brilliant. People that need to chill chew on ice. As far as I’ve experienced, that’s not a professional opinion.

[08:05]
Dr Clifford Yudelman – OptiSmile
Yeah. You’re very, very clever. Very sharp today, Doctor.

[08:10]
Eon Engelbrecht – E-Radio-SA
You’re always clever, but I mean, today you’re very sharp with all these puns.
Yes. So, what you’re also saying is that basically if people crave ice or even other things like eating sand or whatever, it could be a sign of low iron or could it be that you’re pregnant or something?

[08:39]
Dr Clifford Yudelman – OptiSmile
Yeah. So, I mean, it’s just a classic red flag for iron deficiency. I’m not sure about pregnancy.

The best step is just to get tested and if that deficiency is corrected, apparently often the ice obsession magically disappears, saving your teeth from further damage. So, that’s an interesting intersection of medical and dental health. So, yeah, if it’s something you’ve done or maybe it’s a craving you’ve had recently, you’ve picked up from somewhere, get your iron tested.

[09:20]
Eon Engelbrecht – E-Radio-SA
All right. Okay. Very interesting.

[09:25]
Eon Engelbrecht – E-Radio-SA
Okay. So, let’s move on now. Doctor, ice chewing, does it affect your fillings, your crowns or your veneers differently than your natural teeth?

[09:40]
Dr Clifford Yudelman – OptiSmile
Yes. In some ways, it’s worse for those things. So, each filling or crown margin is a seam that can be compressed or compromised by repeated stress and impact.

And with veneers, you risk chipping the porcelain edges. Fillings can crack or leak. Just speaking about veneers, we did an episode on bonding versus veneers versus injection moulding, and then two episodes about looking after your bonding, looking after your injection-moulded composite bonding.

So, if it’s something that you have or you’re thinking of doing, go back and listen to those episodes. And we speak about nail biting and ice chewing in those. Normal fillings can crack or leak, letting bacteria in and causing decay beneath.

You know, your fillings and your restorations are strong, but they’re not bulletproof. And ice chewing will definitely shorten the lifespan of any dental work, and that’s an avoidable expense. And you know, some people, it’s just such a habit, much like nail biting and lip biting.

People often find it very difficult to give it up, which is why we did three separate episodes.

[11:16]
Eon Engelbrecht – E-Radio-SA
Okay. And also, we mentioned previously or you mentioned TMJ problems.
So, I want to ask you, can ice chewing actually strain your jaw muscles and essentially worsen your TMJ problems?

[11:30]
Dr Clifford Yudelman – OptiSmile
Absolutely. The jaw exerts a significant force to crack ice.

I’m talking more about big ice cubes or some that have partially melted. If it’s in America, not so much in South Africa, you get this crushed ice. It’s a big thing, crushed ice.

You don’t get it so much maybe in a margarita or something, but generally, it’s been blended, so it’s much finer. But they do this more coarse crushed ice in the States, and that’s a bit easier to chew on and crunch, and people tend to chew on that. But it’s people that go and crack into big ice cubes.

You know, if you already flinch or have TMJ discomfort, adding in ice chewing can really exacerbate or make muscle fatigue worse, can make joint inflammation worse. You might notice more morning stiffness in the jaw or tension headaches if you’re chewing ice at night. The next day, you’ll suffer.

And, you know, basically, it’s your masseter muscle, which is that sort of muscle that when you clench, it sticks out on the side of your jaw. It’s basically saying, I’m exhausted from chewing this super hard substance. And over time, that can lead to persistent facial or jaw pain.

[13:10]
Eon Engelbrecht – E-Radio-SA
And what are the early warning signs that ice chewing is actually harming your teeth? Will you be able to see it or feel it?

[13:25]
Dr Clifford Yudelman – OptiSmile
Yeah, so when you’ve got patients that are ice chewers and in certain lights, or you take a photograph with a macro lens and a strong flash, or when we scan patients with our iTero scanner, which shows it’s got near infrared imaging, we can see a lot more tiny hairline cracks in patients that chew ice, edges or sharp edges, corners that are just suddenly chipping off, constant chipping, increased sensitivity to hot and cold, a tooth that feels slightly loose, that repeated pinging sensation when biting, especially on releasing.

That can happen after a chewing accident, which is like if you’re eating a hamburger and there’s a little piece of gristle or bone in there, and you’re chewing on something soft, and all of a sudden you hit something hard, or if you’re eating a salad, or you’re eating like a soft salad, and then there’s, say, cashews in there or some other kind of nuts, and you hit a bit of a shell, for instance, or I say it’s like biting on a ball bearing, you don’t expect the next thing.

And then after that, you’ve got this rebound pain, which only hurts with cold or when you put a little bit of pressure, and then you release, like if you’re eating tough biltong, you bite harder, and as you release, you get that pain. If you notice any of these things that I mentioned, it’s time to stop the ice, or you’ll risk major breakage.
Yeah, you’ve been warned there.

[15:10]
Eon Engelbrecht – E-Radio-SA
Okay, and… But save your money, save your money and save your teeth in this case.

[15:20]
Dr Clifford Yudelman – OptiSmile
Exactly.

[15:25]
Eon Engelbrecht – E-Radio-SA
And doctor, any tips? How can someone break this habit if it’s becoming addictive or even stress-related?

[15:35]
Dr Clifford Yudelman – OptiSmile
Yeah, I’ve especially put down a few bullet points here to help people, because one thing saying don’t do it, but I think if you can identify triggers, ask yourself, are you chewing ice when you’re stressed or when you’re bored? What triggers you to start doing it? Substitute, as I mentioned, you can maybe switch initially to crushed ice or more of a slushy-type drink that’s not as hard. Or probably something that’s even healthier is why not grab a cucumber, which is cold and still is crunchy and it’s good for you.

There’s a lot of good stuff in cucumbers, especially if you eat the skin, or maybe some baby carrots, which are really nice. In South Africa, we have amazing vegetables. We’re so lucky. They actually, the carrots taste like carrots. I might have mentioned I lived in Australia for 12 years and I was in California before that, and I think we have the best fruits and vegetables. Why not go for a cucumber or a carrot instead for crunch?

If you want to put your baby carrots in the fridge, I mean, normally, yeah, I mean, they retain the cold nice and it’s sort of a similar kind of feeling. And then if it’s stress management, if it’s stress related, if it’s anxiety, why not try deep breathing or some meditation exercises or get yourself a stress ball that you can squeeze the heck out of rather than breaking your teeth. I mentioned already, if you suspect any kind of iron deficiency or you haven’t had a full blood count, I’m a big one for getting full blood tests at least once a year.

I don’t think a lot of people in South Africa are proactive enough with their general health in mind. They only go to a doctor when they have a problem, but why not get things tested, get your iron levels checked, get your vitamin B checked, unrelated to ice chewing, it’s just my general advice. A lot of people are very low in vitamin B these days and vitamin D, and we don’t get enough sunshine. We’re putting on sunscreen and these are things that are easy to sort out and then stay hydrated. So some people chew ice when they’re thirsty. So sipping on ice-cold water can give you that same refreshment without having to just crunch on the ice.

[18:20]
Eon Engelbrecht – E-Radio-SA
Okay, and also now that you mentioned the cucumbers, I want to add gherkins, those massive gherkins that you get in those glass tins. I think that would be quite nice as well for a crunch.

[18:30]
Dr Clifford Yudelman – OptiSmile
Yes, but be careful with too many gherkins as a regular habit because we did an episode about sensitivity and putting hot water and lemon and eating acidic things and pickles or pickled cucumbers or gherkins.

A, I think there’s also sugar in there, but there’s a lot of vinegar. Anything that’s very sour or tart means that it’s acidic and then that can cause other problems like acid erosion on your teeth or even eat in between your fillings and your tooth. So thanks for helping with the gherkins, but I think stick with cucumbers or carrots.

[19:05]
Eon Engelbrecht – E-Radio-SA
Okay, wow. Well, I just learned something there, I didn’t know that. Or a piece of cheese.

[19:10]
Dr Clifford Yudelman – OptiSmile
After the gherkin, maybe nibble on some cheese, which will neutralise the acids and it’s also good for your teeth. And it also kills your appetite so you won’t snack on too many carbs. That’s some good advice there, Doc.

[19:25]
Eon Engelbrecht – E-Radio-SA
Moving on now, people saying, hey, but I eat crushed or soft ice. Wouldn’t that be safer or is that still risky?

[19:35]
Dr Clifford Yudelman – OptiSmile
Yeah, look, it’s safer than the solid cubes, as we were saying earlier, but it still has a risk if you’re chewing it habitually. Even though it’s less dense, you can still get micro cracks with enough frequency. It’s like chewing on sand rather than chewing on rocks, you don’t want to eat either. The best approach is to let the ice melt in your mouth.

So if you’ve got some crushed ice and you just let that melt in your mouth, it might work for you. Or as we mentioned, find an alternative crunchy snack. Even talking about crunchy things, almonds are good for you and raw cashews, things like that, and lots of minerals, it’s good for you if you’re looking for something crunchy.

[20:00]
Eon Engelbrecht – E-Radio-SA
And then, Doctor, any final advice for all our ice chewers listening today?

[20:05]
Dr Clifford Yudelman – OptiSmile
Just to recap, ice chewing is a classic example of a refreshing treat that can become a destructive habit. And if you can’t resist it, try and figure out why. Is it stress? Is it thirst? Is it iron deficiency? Address it. Because once you crack a tooth or you break a crown or a veneer, you’re looking at a big dental bill and all over something as simple as frozen water. So weigh it up. Is that crunch really worth the potential cost and pain? I’d say not. A little mindfulness and maybe a trip to the doctor for your blood test can keep your teeth safe and your wallet intact.

That’s a good final piece of advice when it comes to ice chewing. I hope the nail biting and the lip biting and the ice chewing episodes helped people that suffer from that. Do tune in next week where we will be covering something that I get a lot of questions about lately, which is mouth taping and nasal breathing.

That’s a popular subject these days. It’s all on TikTok and on the news. Sounds interesting.

Yeah. So thanks for all the questions on these para-functional habits. And yeah, looking forward to speaking to you next week.

Dr Clifford Yudelman, thank you so much as always. And also to our listeners for tuning in. We thank you.

Remember, while we strive to provide valuable insights with these podcasts, always consult with your own dental professional for advice tailored to your personal health. Don’t forget to subscribe to the podcast for more enlightening discussions. Join us again next week as we continue to explore the fascinating intersection of dental health and financial savvy.

Until then, keep smiling and taking great care of your teeth.

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