What is a hearing aid dome? How do I take care of mine?

Thanks to a tiny device known as a hearing aid dome, many modern hearing aids are providing their users with better sound quality than ever before.

What is a hearing aid dome?

Domes are small, bell- or mushroom-shaped flexible silicone pieces that attach to the end of hearing aid tubing and fit deep in the ear canal. They're also known as tips.

The dome's job is to protect a tiny speaker that delivers sound deep in the ear. They come in different shapes and sizes to accommodate the unique twists and turns of each person's ear canal.

Domes are usually used with behind-the-ear styles of hearing aids, referred to as either receiver in the canal (RIC) or receiver in the ear (RITE). Domes are connected to the unit via a wire contained in a thin tube. These aren't one-size-fits-all: Your hearing healthcare provider determines the correct dome and tubing for the width and length of your ear canal.

These styles "put the loudspeaker deep in the ear canal and keep the processor and microphone on top of the ear," explained Tom Contento, a board-certified hearing aid instrument specialist and owner of Contentment Hearing Care in Titusville, Fla.

Is a hearing aid dome right for me?

Hearing aids with domes are best for those with mild-to-moderate hearing loss, especially those with high-frequency hearing loss—the most common type of age-related hearing loss, known as presbycusis. 

Hearing aids with domes are generally best for those with mild-to-moderate hearing loss.

These hearing aid devices are typically small, with a microphone and processor that fits in a small case and rests behind the ear. The speaker is attached to the processor by a thin tube or wire, and it's meant to fit deep inside the ear canal.

This style of hearing aid is not recommended for those with severe-to-profound hearing loss; instead, a behind-the-ear device using earmolds is often more suitable. Earmolds provide the most powerful amplification and are less susceptible to moisture damage from the ear canal.

But “in a lot of cases, it’s personal preference by patient and [practitioner],” Contento said, meaning that people with mild-to-moderate hearing loss can still use earmolds, if they prefer. 

What are the pros and cons of hearing aid domes?

Pros

One of the biggest advantages to wearing a dome is the way it fits inside the ear canal. They allow low-frequency sounds to still arrive in the ear, known as an "open fit," making them ideal for people who can still hear lower frequencies (such as thunder or a car engine rumbling).

“The important thing about hearing aids is we must vent the hearing device so the ears don’t get occluded,” Contento said. This allows some natural sound and airflow to come into the ear. “Domes are open enough to let low frequencies come through so the hearing aid amplifies higher frequencies and you can hear more clearly. That’s how we get better high frequencies without acoustic feedback.” 

Domes are easily cleaned by wiping them with a soft cloth each night after use. (Here's how to gently remove earwax from hearing aids.) Because some hearing aid manufacturers share dome styles and sizes, they are also relatively inexpensive to replace if lost or damaged.

Cons

“But they don’t last forever,” Tom said. “Domes must be changed every two to three months. And if a person isn’t careful, it can get stuck in their ear if they are in a hurry or too lazy. That doesn’t happen if you do it right.”

To prevent problems, talk to your practitioner about how often to change your hearing aid domes and how to take care of them. Never use old domes on new hearing aids. They're not always compatible and can become stuck in someone's ear canal if they don't stay attached to the receiver.

Also, domes are susceptible to damage from earwax or moisture in the ear. Lastly, their small size can be problematic for those with dexterity issues. 

A good fit is key to good sound

Contento encourages users to work with a hearing care provider, such as a hearing instrument specialist or an audiologist, to find the device that best addresses their particular hearing needs. An improper fit can affect your ability to hear clearly as well as cause pain or discomfort. It can also trigger feedback, causing a high-pitched whistling sound.

“No two people process sound the same way so it’s important to make that determination on a case-by-case basis,” he said. 

Next steps

If you are diagnosed with hearing loss and hearing aids are the prescribed treatment, work with your professional to determine which device is best for the severity of your loss as well as for your lifestyle and budget.

If you need help with hearing loss, visit our directory of consumer-reviewed hearing loss clinics to find a center near you.