By Rohima Badri, Ph.D.
October 2022 is an exciting month for those who have been waiting for hearing aids to improve their hearing but have been unable to do so due to cost and access issues. Over-the-counter (OTC) hearing aids, which are set to be available this month, are a new Food and Drug Administration–regulated category of devices designed to help adults with perceived mild to moderate hearing loss and can be purchased without consulting with a hearing healthcare professional. OTC hearing aids will be sold both in-person and online, and it is critical that you educate yourself and, as with any purchase, weigh the benefits and drawbacks.
The Good
Approximately 15 percent of American adults, or 37.5 million, ages 18 and up report hearing problems, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). In 2011, Johns Hopkins University determined this number jumps to 48 million when including Americans ages 12 and older reporting hearing loss in one ear.
And the vast majority of them have mild to moderate hearing loss, according to a 2016 report in the American Journal of Public Health. The NIDCD estimates that nearly 30 million adults in the United States could benefit from wearing a hearing aid. Additionally, a sizable population reports hearing difficulties in challenging situations despite having clinically typical hearing. In these populations, OTC hearing aids can help them hear better by making sounds louder and by increasing speech signals in the presence of background noise. Adults with hearing loss who would benefit from using hearing aids will now be able to take advantage of a wide array of less expensive options with this new class of hearing aids.
Additionally, as the use of hearing aids increases, so will general health and well-being. Hearing health is critical for physical, mental, and social well-being. Untreated hearing loss, on the other hand, is on the rise and has been linked to isolation, depression, falling risk, and dementia. Access to hearing aids that are simple and affordable will improve health and overall quality of life. It's also comforting to know that, unlike other personal sound amplification products available today, over-the-counter hearing aids will be regulated by the FDA.
The Bad
Despite the excitement surrounding OTC hearing aids, it is important to remember that this class of hearing aids is designed for adults only with mild to moderate hearing loss, according to the FDA. Furthermore, people who experience sudden hearing loss, ear pain, tinnitus, dizziness, or any other new ear-related symptoms should avoid using OTC hearing aids without first consulting a medical or hearing professional.
Unfortunately, with the frenzy of hearing aid affordability and ease of access, many people with hearing loss beyond moderate severity may turn to OTC devices.
Under-amplification can have serious consequences for people seeking to treat their hearing loss. People who don't meet their amplification needs may not only face communication difficulties but also experience frustration, disappointment, and worst yet, give up on the hearing aid altogether.
The Ugly
One major and immediate concern is how the availability of OTC hearing aids may impact the safe use of hearing aids in pediatric patients. The FDA has not approved OTC hearing aids for children under the age of 18. However, given their accessibility and low cost, there is always a risk of parents and other caregivers trying OTC devices.
This could seriously jeopardize the children's hearing as well as their growth and development. Proper fit and follow-up care are critical in this age group because good hearing is critical to meeting important speech and language milestones and acquiring vital academic, social, emotional, and cognitive skills. Children must be tested adequately, fitted properly, and receive comprehensive hearing care from a team of medical professionals in order to be well integrated and set up for success. However, the availability of OTC hearing aids can be a liability for the pediatric population.
Another major concern with the introduction of OTC hearing aids is the lack of guidance and follow-up care that comes with professionally fitted hearing aids. Hearing aids aren’t as easy to use as eyeglasses. The success of the hearing aid fit and their continued use is heavily dependent on the post-care, counseling, and guidance that hearing aid patients receive from professionals such as audiologists and hearing aid dispensing specialists.
One of the most common reasons why people who have been fitted with hearing aids refuse to wear them is a lack of support and follow-up counseling regarding hearing aid care and maintenance, reports a paper in the International Journal of Audiology in 2013. That study also revealed that hearing aid use was often discontinued due to discomfort or a lack of knowledge about properly inserting them, both of which can be easily remedied during follow-up counseling. Aside from the risk of inadequate testing and over- or under-amplification, a major disadvantage that should be considered before purchasing OTC hearing aids is the lack of ongoing counseling on the use and care of hearing aids.
Conclusion
Hearing aids are never “one size fits all.” Our satisfaction and decision to keep and wear our hearing aids consistently will ultimately depend on how well they fit our hearing loss, hearing needs, and lifestyle. So, before getting excited and shopping for OTC hearing aids, get educated, talk with your doctor, and make an informed decision in order to avoid disappointment and reap the full benefits of OTC hearing aids.
A New Jersey resident, audiologist Rohima Badri, Ph.D., is a hearing healthcare adviser for HHF’s Keep Listening prevention campaign.
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