Hearing loss in the dental profession

Estimated reading time: 5 minutes

Among dental professionals, hearing loss has been identified as a common condition that needs to be addressed early. By Kerryn Ramsey

It is an unfortunate fact that dental professionals are at risk of damaged hearing. A 2023 study from Oxford University found that approximately 82 per cent of dentists and oral health specialists suffer from hearing loss. The level of noise from drills, compressors, autoclaves and ultrasonics have a negative effect on hearing.

“A harmful level of noise is anything above 85 decibels continuously for an eight-hour period,” says Aklesh Nand, Occupational Health and Environment manager at SafeWork New South Wales. “In a dental surgery, the noise of drills and other equipment may be below what is considered a damaging level, but cumulatively over an eight-hour day, it can be above a safe level.” 

Some hearing loss in dentists may also be attributable to presbycusis (age-related hearing loss) and possible exposure to ototoxins (chemicals that damage hearing).

According to Emma Chaffey, a clinical audiologist and PhD research candidate at Ear Science Institute Australia, a national medical research institute headquartered in Western Australia, the issue is that “prolonged or repeated exposure to loud noise may do as much damage as one-off or sporadic exposure to very loud sound”.

Hearing loss is also insidious. Often, people don’t realise they have a problem until family members or work colleagues notice they have to speak louder to be understood. Sometimes, people need to speak to a person at a specific angle or the television volume needs to be cranked up. Even then, the issue may not be immediately addressed.

“On average, people wait seven years from noticing the impacts of hearing loss before acting on it,” says Chaffey. “By that stage, their hearing has continued to decline. The earlier you start rehabilitation, the easier and more successful it’ll be.”

Read the room

There are professional organisations that can assess a practice or surgery to quantify the sound levels and offer suggestions to minimise the damage. Aklesh Nand suggests contacting the Australian Institute of Occupational Hygienists or the Australian Acoustical Society to organise such an assessment.

“There are many ways for a dental practice to minimise sound levels,” says Dr Barbra Timmer, director and president of Audiology Australia. “It can be as simple as creating a greater distance between you and the noise. The further away the source, the less damaging it will be. Compressors and autoclaves can be moved to adjacent rooms. Baffles and wall panels can dampen the sound of equipment. New equipment should be assessed for noise levels. There are many solutions.”

Gone for good

Hearing loss has a huge negative impact on general health and quality of life. “It was once considered a sensory impairment that affected our communication,” Dr Timmer says. “We now understand that it affects social, emotional and physical wellbeing. The most obvious impact is participating in rapid conversation or when there is background noise.”

Musicians and those working in construction are proactive in limiting the effects by using earplugs and earmuffs. Despite the fact there’s a clear correlation between hearing loss and the dental profession, it’s as if dentistry is a forgotten industry.

“Any dentist or associated staff member who suspects they are suffering hearing loss should be assessed by an audiologist,” Chaffey says. “Getting onto it early and having a baseline hearing test is very powerful. It allows you to track your hearing and equip yourself with knowledge about when and how to act.”

The mechanism that allows for hearing are fine hair-like protrusions called stereocilia. They convert the mechanical energy of sound waves into electrical signals that are transmitted to the brain as sound. The initial response to noise is called Temporary Threshold Shift, where the stereocilia are injured but can recover. If the noise exposure continues this can progress to Noise Induced Hearing Loss which is permanent.

“Unlike other cells in the human body, if stereocilia dies, it is not replaced,” Nand says. “This means that hearing loss is irreversible—once it’s gone, it’s gone for good.”

The only option then is to manage the condition as well as possible.

“There’s very good rehabilitation for hearing loss, and hearing aids are a proven tool that improve hearing and communication,” Chaffey says. “There is also a large range of other products that can potentially improve hearing in different situations”.

Personal solutions

Earplugs are an effective solution to protect dentists’ hearing when it’s impossible to avoid noise, particularly from drills. At the same time, they allow for easy communication with patients and other staff members.

“Cheap foam ear plugs work well but may block too much sound,” Chaffey says. “Custom-fit hearing protection offers the best results. They can filter sound more readily and reduce high frequencies that are damaging. A dentist is in close proximity to patients and staff so earplugs should allow speech understanding while providing adequate protection.”

Get tested

Clarity of speech can be another issue that emerges as a result of high-frequency hearing loss.

“The most common way we manage measurable hearing loss is through hearing aids,” Dr Timmer says. “They can provide amplification in the regions that the person needs. There is also auditory training and we can teach communication strategies that take a more holistic approach.”

With such clear evidence of hearing loss in the dental profession, all dentists and allied staff should need to make having their hearing assessed a priority. This becomes even more essential as people get older and age-related hearing loss starts to occur.

“I strongly recommend that all dental staff get a baseline hearing test,” Dr Timmer says. “Then get your hearing checked once a year. It’s a sensible proactive measure similar to a dental check-up every six months.”