Experts urge caution with over-the-counter hearing aids

The Biden administration has expanded access to over-the-counter hearing aids, but some audiologists are concerned that people who are hard of hearing won’t get exactly what they need.

Administration officials say that a recent executive order lowers the price of hearing aids and allows more people to access them. The hearing aids that are becoming available over-the-counter are for people with mild to moderate hearing loss, the Food and Drug Administration said.

“Audiologists use labels like mild, moderate and severe to describe hearing loss, referring to objective test results,” said Stelios Dokianakis, a practicing audiologist in Holland, Michigan.

Those with mild hearing problems may benefit from over-the-counter aids, Dokianakis wrote in an email.  Such hearing aids “can be a positive change in access to care, and may also help remove the stigma associated with hearing aids, especially as we see younger people using hearing aids.”

However, audiologists are most concerned about those with severe hearing loss.

“People with more severe hearing problems will not find sufficient benefit,” Dokianakis said.

If people buy an over-the-counter hearing aid, they are using their own best judgment to determine what is best for them, said Jerry Punch, a retired audiologist in Ingham County and a professor emeritus at Michigan State University. This could mean getting one that either over- or under-amplifies sound.

If people use an aid that is over-amplified for their personal needs, they could damage their ears,  making their hearing worse, Punch said. Aids do have maximum outputs, and as technology improves, the danger of this decreases. 

The main reason for hearing loss is a gradual decline in nerve function, Dokianakis said. But there are several other reasons a person’s hearing might be impaired.

“From wax in the ears to growths, tumors, drainage and middle ear fluid or pressure, hearing loss is a common symptom for several problems that may require a medical solution rather than an over-the-counter device” Dokianakis said. “Delaying assessment for some of these problems can create bigger issues and complicate or limit treatment options.”

Dokianakis also cited concern about the impact over-the-counter aids could have on children with hearing loss.

“Pediatric hearing loss is a problem that needs expert assessment and appropriate intervention,” Dokianakis said. “Without that, we will see speech and language delays, and, if sound is too much in tiny ear canals, further hearing damage. I sincerely hope that people do not attempt to use OTC hearing aids on children for reasons of convenience or saving money.”

As long as the aids are used correctly and people are not self-diagnosing, over-the-counter aids will have a positive impact on people who are hard of hearing, both Dokianakis and Punch said.

“The best OTC option currently, to offer a balance of cost savings with the fewest sacrifices, may be for patients to see a professional before purchasing a device,” Dokianakis said. “An educated consumer will make better choices.”