Information for Consumers

Prescription Hearing Aids

vs.

Over-the-Counter Hearing Aids:

What Are Prescription Hearing Aids?

Prescription hearing aids are medical devices chosen, selected with specific prescription needs, fit, and programmed by a licensed hearing care professional. Prescription hearing aids have a broad fitting range, making them appropriate for individuals with hearing levels ranging from normal to a profound loss. The brand of hearing aid also matters.

Key Features:

Requires,a,comprehensive hearing evaluation by a licensedaudiologistincludingmiddle ear testing and inner ear testing.
Requires,speech in noise testing, tinnitus evaluations as needed, and ultra-high-frequency testing
Effective fitting depends on individual ear acoustics and hearing science
Programmed based on your specific hearing test results, and extreme caution is taken for pitches/areas where a person still has hearing within normal limits.
Requires professional expertise with fitting formulas
Requires in-person verification of programming via real ear measurements/speech mapping
Requires in-situ testing: Measures hearing thresholds directly through the hearing aid for a more accurate, personalized fit that accounts for individual ear canal acoustics.
Ongoing follow-up care, adjustments, and counseling for you and your loved ones from an audiologist
Advanced technology from leading brands in the industry for background noise, speech clarity, tinnitusmanagement, and Bluetooth connectivity.

What Are Over-the-Counter (OTC) Hearing Aids?

OTC hearing aids are self-fit devices available without a prescription. They are designed for adults who have a mild to moderate flat hearing loss.

Key Features:

Purchased online or in retail stores.
No hearing test required.
Users can adjust settingsthemselves using buttons or a smartphone app.
Lower cost.
Lack of customization and individual programming of hearing aids.
Limited or no support.
Entry basic-level technology (provides basic sound and shaping).
Most lack directional microphones (for complex noise reduction features).
Makes everything louder but not necessarily clearer

Though OTCs provide cost-effective options for individuals with one M < type of hearing loss if they are used with other specific types of hearing losses this could lead to severe issues including generalized amplification, distortion, unpleasant loudness, increased risk to one’s current hearing, and speech understanding issues

1. Generalized Amplification

OTC hearing aids are designed to amplify sound uniformly across all frequencies, which means they don't consider the specific frequencies that need more help in individuals with hearing loss.
For someone with high-frequency hearing loss, for example, certain higher-pitched sounds (like speech consonants or birds chirping) are harder to hear, but the lower frequencies (like bass sounds) are usually preserved.
If these devices amplify all frequencies equally, it can lead to over-amplification in areas where hearing is normal or even sensitive which can result in discomfort and distortion.

2. Distortion and Unpleasant Loudness

When the amplification is too broad, evennormal soundsthat should be easy to hear can becomedistortedortoo loud. This makes the sound unnatural and can reduce the clarity of speech or other important sounds.
For someone with mild to moderate hearing loss or a mild conductive hearing loss(CHL), this kind of amplification can exacerbate the situation. Soft speech sounds might be too loud, while normal conversations might become muddy or garbled

Below is an example of a mild conductive hearing loss(CHL). With a CHL a patient will have a hearing loss that is not in the cochlea or the auditory nerve. Instead, these patients may have a blockage like earwax, fluid buildup, an infection, negative pressure, or damage to the tiny middle ear bones. This will affect sound transmission through the outer and/or middle ear to the inner ear(cochlea and auditory nerve), which can make sounds seem quieter or muffled.

Many times ,a patient may have an untreated CHL and not even know if they have this type of issue and will get OTCs before consulting their physician or having an audiological evaluation, which can cause further issues.

3. Potential Risk to Hearing

OTC hearing aids will over-amplify these types of hearing losses ,which could damage hearing in areas where there's no existing loss. If the volume is cranked too high, it can actually harm sensitive parts of the ear (e.g., the cochlea) that are still functioning well, particularly in the low-frequency range.

Below is an example of a mild “cookie-bite” hearing loss. The normal hearing range is towards the top of thesegraphs between-10 dB HL and 20 dB HL (the numbers on the left side of the graph). If a patient with this hearing loss were to use OTC hearing aids, everything would be amplified whether they needed it or not. The areas where this patient has no hearing loss will be overamplified, which can result in additional hearing loss.

Prolonged exposure to loud sounds, even if they seem normal or soft to the person with hearing loss, could potentially worsen the hearing situation over time.

4. Speech Understanding Issues

Because these devices don’t have the precision of more customized, professionally fitted hearing aids, it can be harder to understand speech, particularly in environments with background noise.

Below are two examples of hearing loss types(sloping and rising hearing loss)that would not do well with OTC hearing aids because they have various frequency responses that are within the normal hearing range which is between -10 to 20 dB HL. Customized hearing aid programming is necessary for these types of hearing losses to get the maximum speech understanding.

The amplification might interfere with the way speech is processed, making it harder to distinguish between important sounds and background noise

So what is the best alternative for your specific hearing needs?

Professionally Fitted Hearing Aids

Custom-programmed hearing aids are a better solution for those with specific hearing loss patterns. These hearing aids are calibrated by an audiologist to address the unique needs of an individual's hearing loss, amplifying the frequencies where there is diminished hearing and leaving others unaffected.
They also allow for fine adjustments, such as adjusting for different listening environments, which OTC hearing aids cannot do as effectively.

So, while OTC hearing aids can be helpful for those with minor or generalized hearing issues, they’re not a one-size-fits-all solution, especially for people with specific hearing loss types. It’s important for people to be mindful of these issues when considering them.

Please remember custom prescription hearing aids cost more because each device is programmed specifically for each ear by a professional. Understanding this is crucial when making your decision and consulting a professional hearing specialist can provide the best solutions.

Call today to arrange a comprehensive hearing test. Knowing your exact hearing loss can make all the difference, and our audiologists are experts in personalized hearing aid solutions.