Making the Right Choice: Hearing Aid Domes or Earmolds – Pros and Cons

Hearing aid domes are small medical-grade silicone attachments (usually transparent, gray, or black) that fit into the ear canal. They come in cone or dome shapes and range in size from 4mm to 12mm. The types of domes are open, vented, closed, and power.

Hearing Aid Domes Comparison

Type of DomeIdeal forAdvantagesDisadvantages
Open DomeMild to Moderate Hearing Loss with High-Frequency LossAllows sound to enter the ear and pass the hearing aid naturally, only changing the frequencies in which you have hearing loss.Not suitable for low-pitch losses, can cause feedback issues for those with moderate hearing loss
Closed DomeModerate Hearing LossBetter amplification of lower-pitch sounds provides a more balanced and robust sound experienceCauses occlusion (changes the way your own voice sounds)
Power DomeSevere Hearing LossProvides maximum amplification while minimizing sound leakageLess comfortable than a custom earmold.
EarmoldMild to ProfoundEasy to insert, no feedback, more comfortable for someOcclusions for those with good hearing. Costs more.

As an audiologist, I suggest considering the type of hearing loss when choosing a hearing aid dome to ensure the best sound experience.

Open Dome

This type has vents that let sound into the ear and past the hearing aid. It is ideal for those with mild to moderate hearing loss and high-pitch loss. However, it may not be suitable for low-pitch losses and can cause feedback issues for those with moderate hearing loss.

Closed Dome

A closed dome, also known as a vented dome, has less ventilation than an open dome, allowing for less air and external sound to enter. This leads to better amplification of lower-pitch sounds, providing a more balanced and robust sound experience. If you have normal hearing in the low frequencies, this can lead to occlusion. I suggest closed domes for those with moderate hearing loss.

Tip: A closed or vented dome is also what makes streaming sound quality better.

If you have trouble removing a dome, check out this tool.

Power Dome

For those with severe hearing loss, power domes occlude the ear canal, providing maximum amplification while minimizing sound leakage. I generally recommend a custom earmold instead of a power dome.

Custom Earmolds

Hearing aid with earmold attached.

Custom ear molds have several advantages over rubber domes. For example, custom ear molds can have custom venting inside the ear, which allows the hearing care professional to control the vent size, determine whether sounds be amplified, and reduce background noise. They can also offer better music streaming and trap low-frequency bass tones for a richer, full sound. Additionally, custom ear molds can have canal locks, helix locks, or skeleton locks added to prevent the hearing aids from falling out.

How Will Custom Molds Be Made?

When domes are not functional for hearing loss, audiologists take custom ear impressions to make custom earmolds. They do this by creating a mold of the individual’s ear canal. This process usually involves the following steps:

  1. Preparation: The audiologist will clean the ear to ensure there is no cerumen. Then place an otoblock (a small piece of foam or cotton down into the canal to stop the impression material from going too deep).
  2. Impression Material: The audiologist will then apply a soft, pliable material, such as silicone, into the ear canal. The material will harden and form a mold of the individual’s ear canal. The material hardens in 4-5 minutes.
  3. Removing the Impression: After the material has hardened, the audiologist will remove the mold from the ear and make any necessary adjustments.
  4. Sending the Impression to the Manufacturer: The final impression is then sent to a manufacturer, where a custom earmold is made based on the mold.
  5. Fitting the Earmold: The audiologist will then fit the custom earmold to the individual’s ear to ensure a comfortable and proper fit.
  6. Checking the Fit: The audiologist will check the fit of the custom earmold and make any necessary adjustments to ensure maximum comfort and sound quality.

The process of taking custom ear impressions is quick and painless and provides a perfect fit for the individual, ensuring maximum comfort and sound quality.

Earmolds are also easier to insert into an ear canal than a dome and are best for those who have dexterity issues.

Making the Decision on What Type to Use

Unsure if you want to rock the dome or go for the earmold life? Just consult with your audiologist; they’ll recommend what’s best for your specific hearing loss situation.

When choosing between a rubber dome and a custom earmold, a knowledgeable audiologist will consider an audiogram to determine the most appropriate type of ear coupling. They will consider what speech information is able to reach the brain without amplification and what information requires amplification based on the severity of the hearing loss. For example, for mild high-frequency hearing loss, an open rubber dome is appropriate, while for severe to profound hearing loss, a custom earmold without a vent or with a very small pressure vent is critical.

If you are planning on using over-the-counter hearing aids, use an open dome, unless you are streaming a lot, then you may want a closed dome.

If the dome life isn’t for you, then you can always upgrade to the earmold life for a better fit.

And remember, keeping your ears clean and free of impacted earwax is important for anyone wearing hearing aids. You don’t want earwax to be the reason you miss out on all the good jokes!

Jonathan Javid Au.D.

Jonathan Javid Au.D., a seasoned audiologist with an extensive background in the field of audiology. With over 11 years of invaluable clinical experience, Jonathan has dedicated his career to helping individuals enhance their hearing and improve their quality of life.

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