Who is not a good candidate for an OTC hearing aid?

With the recent FDA approval of over-the-counter (OTC) hearing aids, there has been a lot of excitement about the potential for easier access and lower prices. However, the FDA has made it clear that over-the-counter hearing aids are not a single solution.

Instead, for some people, the best option is to skip drugstore hearing aids for professionally fitted hearing aids, i.e. “prescription” hearing aids. These types of hearing aids are available at clinics staffed by audiologists and/or hearing aid professionals. When you visit a hearing clinic, you can expect a full hearing evaluation and a personalized treatment plan.

Who shouldn’t get OTC hearing aids?

So how do you know if OTC hearing aids won’t work for you? This is by no means an exhaustive list, but here are some of the main reasons:

medical reasons

Severe or profound hearing loss

OTC hearing aids are only intended for people with mild to moderate hearing loss. People with severe or profound hearing loss need specialized high-powered hearing aids or surgically implanted devices like cochlear implants. Do you have trouble hearing normal conversation, even in quiet environments? If you have severe or profound hearing loss, you will likely need a more powerful device which can only be obtained through a licensed professional.

History of ear infections or fluctuating hearing loss

People with a history of chronic ear infections or fluctuating hearing loss should seek help from a hearing care professional. Why? Your ear anatomy and hearing loss may present unique challenges that require custom-fit earmolds or other hearing aids.

Children and adolescents (early onset)

OTC hearing aids are not designed for children with hearing loss. Children’s hearing aids should be programmed and optimized to help them do their best in school. Additionally, children’s ears change shape as they grow, requiring custom earpieces and specialized pediatric hearing aids.

Sudden onset hearing loss

Anyone experiencing a sudden change in hearing should immediately seek medical attention from an ENT doctor or emergency department. Sudden hearing loss may be a sign of another medical condition and should be evaluated, especially if accompanied by dizziness and/or tinnitus (ringing in the ears). If treated quickly, it is possible to restore hearing. If hearing is not restored, you will likely need prescription hearing aids from an experienced provider.

Unilateral (unilateral) or asymmetric hearing loss

If you have hearing loss in both ears but one ear hears better than the other, an over-the-counter hearing aid is not an appropriate treatment option. The same is true if only one ear has hearing loss. Instead, the first step should be to see an audiologist or ENT to rule out other medical conditions that may be causing this type of hearing loss. After that, specialized hearing aids can address your unique type of hearing loss.

Unusual geometry of the ear canal

People with very narrow ear canals, curved ear canals, or surgical ears should consult a professional before considering an over-the-counter hearing aid. In most cases, a more personalized mouthpiece will be more effective and more comfortable. Also, if retention is an issue, an audiologist can make adjustments to keep your hearing aid comfortably in place.

Personal reasons

Even if none of the above applies to you, you can always see a hearing care professional for specialized hearing care. Some common “personal” reasons people seek in-person care:

Technological challenge

Do you have difficulty using an application on a Smartphone? Having trouble keeping up with technology? You’ll do better with a traditional hearing aid from a licensed professional who can help you with special features such as custom programs, Bluetooth connectivity support, or assistive listening devices like a remote microphone.

Prefer a professional evaluation

When considering OTC, it’s also important to ask yourself how comfortable you are with setting up your own devices independently. A professional hearing assessment provides objective information about the degree of your hearing loss as well as the treatment options that are best for you. From there, it is much easier to make the most appropriate choice, which may include OTC.

People often underestimate their level of hearing loss and the hearing aid fitting process. According to an industry survey, about half of respondents said they don’t be comfortable performing various hearing aid related tasks without the assistance of a hearing care professional.

In my work as an audiologist, I have found that people often underestimate their level of hearing loss and the process of fitting hearing aids.

You are not sure if you have hearing loss

Most age-related hearing loss is so gradual and progressive that it can be difficult to correctly judge what you are missing. The above survey revealed that 68% of people with audiometric hearing loss did not notice any hearing difficulty. This means that by the time hearing loss is noticeable, a person may have developed moderate or more severe hearing loss. For this reason, it’s a good idea to have at least one professional hearing test before pursuing over-the-counter or prescription hearing options.

Are OTC hearing aids similar to reading glasses?

Over-the-counter hearing aids and reading glasses both provide assistance to people who are visually or hard of hearing, but they differ in a few key points. “Readers” are available over the counter, do not require a prescription, and work for a certain subset of the visually impaired population. Similarly, OTC hearing aids are self-adjusting devices that do not require a prescription for purchase and use. The main difference is in their relationship to the brain.

The health benefits of hearing aids include reduced risk of depression, social isolation, and falls.

Hearing is a complex brain process

Specifically, hearing aids involve a longer neurological adaptation period. That’s why some hearing clinics offer hearing training and other therapeutic services that make it easier to wear hearing aids (instead of ending up unused in a drawer).

Additionally, determining your degree and type of hearing loss is more complex than determining reading glass magnification, so it may be beneficial to have hands-on support from an audiologist or other professional in this process to make adjustments and provide assistance.

For those with Medicare, a hearing evaluation is usually covered by a medical referral, and it’s a great way to test your hearing loss as well as speech clarity. Other types of insurance coverage vary and you will want to check with your insurance provider about this benefit.

What happens during an appointment with a hearing care professional?

The traditional hearing aid process involves a visit to an audiologist or hearing aid specialist for a full hearing evaluation, followed by discussion and selection of an appropriate treatment option for the person’s hearing loss. Hearing aid fitting is then provided to customize the settings to the person’s unique pattern of hearing loss. Your hearing care professional will also teach you how to insert and clean the devices, as well as connect them to a phone (if desired).

OTC is self adjusting and buyer beware

OTC hearing aids can be purchased without a hearing assessment or fitting appointment with a hearing care professional. As of October 17, 2022, OTC hearing aids are available at major retailers like CVS and Walgreens and online. These devices are fully self-adjusting, meaning the user controls the volume to a level they deem appropriate. As with other health products sold to the public, beware of the buyer.

Either way, hearing aids have many health benefits

Whether you opt for over-the-counter hearing aids or seek out prescription hearing aids from a hearing aid clinic near you, this is an important first step in your hearing health journey. When worn correctly, hearing aids offer many health benefits: not only will you hear better, but you’ll help your brain stave off future hearing loss and possibly dementia.

To find an experienced hearing care professional near you, you can consult our directory of consumer-reviewed clinics.

About Marion Alexander

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