Musician earplugs and hearing health education can be beneficial to members of other professions, including dentists, who also suffer from hearing loss.
By Catherine Palmer, PhD
The University of Pittsburgh Medical Center Audiology group (UPMC Audiology) currently provides non-custom musician earplugs for every student in the University of Pittsburgh Dental School. This program is paid for by the University of Pittsburgh Dental program. In addition, we provide custom musician earplugs to those students who prefer a custom solution, which is purchased by the students. Each year, we provide a lecture to the new class of dental students (approximately 80 students per year) that includes information about hearing health and hearing protection as well as good communication strategies for working with patients with hearing loss and positioning for individuals with vestibular issues.
This article describes the journey that led us to this relationship with the dental school and a comprehensive hearing care program that is introduced to each student at the beginning of their program. Figure 1 illustrates the steps that led us to this ongoing program.
Getting Started with Hearing Care Education in Dentistry
This program started when dental school professor Thottala Jayaraman, PhD, reached out and asked if someone from the medical center audiology clinic could provide a guest lecture on hearing within the Human Physiology course. The lecture would be 90 minutes long, so we thought about what we could include that would warrant 90 minutes. We decided to break the content down into patient-focused and dentist-focused topics.
For the dental patient, there are issues of untreated hearing loss as it impacts communication and potential vertigo induced by patient position during a visit for individuals prone to benign paroxysmal positional vertigo. There are considerations for those who wear hearing aids (e.g., do they want the drill sound amplified) and there are potential solutions for communication challenges (e.g., use of simple amplifiers when taking the case history, providing instructions, etc.). Awareness of positional vertigo assists the dentist in asking questions that help manage patient positioning in a dental chair to reduce discomfort.
For the dentist, the focus was on the potential for sound induced hearing loss, tinnitus, and hearing challenges over time. In addition, we presented information about hearing protection including the use of musician earplugs to protect the dentists’ hearing, reduce hearing challenges, and reduce the chance of experiencing tinnitus while still maintaining the ability to hear patients. The extended exposure over a dental career to both constant lower level sounds as well as the high intensity sound of drills contribute to noise-induced threshold change as well as cochlear synaptopathy (hidden hearing loss), so these topics were discussed in detail. This filled the 90 minutes.
Introducing Musician Earplugs in Dental School
The second year we brought non-custom musician earplugs to show the group and for any students who came up at the end to ask questions, we gave them a pair of non-custom musician earplugs. This prompted a handful of students to reach out to purchase non-custom earplugs from our clinic. By year three, our guest lecture was a permanent part of the course, so all dental students received information on hearing health and hearing protection toward the beginning of their program.
It was in year four that we learned that one of the most sound-intense exposures in the dental school program is in the first year when the students are all practicing drilling on models in one laboratory space. In year five, an interested student named Stephanie Cisek went to the Dental School administration and asked that hearing protection be provided for all incoming students. The reasoning being that they learn about the need to protect their hearing from activities that are part of their educational program and therefore, like any other safety equipment that is provided in the program (gloves, masks, eye protection), hearing protection should be provided as well.
Instrument Management Service Manager Kristen Felser rose to the occasion and worked with the student and our group to make this program a reality. The school now purchases non-custom musician hearing protection for all students and faculty. Cisek was interested in custom hearing protection and worked with our group to create a discount that is offered to the dental students if they want to individually purchase custom musician earplugs. To accommodate their very busy clinic schedules, we hold a specialty clinic before regular clinic hours a few times a year to make custom musician earplugs for interested students.
Further reading: NIOSH Study Tracks Usage of Hearing Protection
Elements of a Successful Hearing Protection Program
This journey illustrates the steps that we have found essential in developing hearing loss education and prevention programs with a variety of groups, including the numerous high school and college bands and university schools of music with whom we work. Our most successful, sustained programs start when the entity reaches out to us as opposed to us reaching out to them to convince them that they need to provide education and/or action related to hearing protection.
This does not mean that audiologists should not promote hearing protection. We do this through information on our website (e.g., we have a Musicians’ Hearing Center) and we promote hearing protection at community health fairs and in talks whenever possible. But our experience indicates that the group needs to have their own motivation to pursue these programs. Perhaps someone in leadership has become more aware of the importance of hearing and the risk of hearing damage due to the activity. Or a student has experienced a hearing protection program in a previous activity (e.g., high school band prior to joining a university band).
Tailoring our response to the actual request is critical. If the group simply wants education, that is what we provide. Rather than jumping right to proposing a comprehensive hearing protection program, we have found that the education leads organically to this conclusion—that the entity needs to provide hearing protection or at least provide access to hearing protection for their constituents. Again, we have been more successful when the interested group asks us to partner with them to provide needed hearing protection along with the ongoing educational program rather than when we are the party asking for a hearing protection program to be put in place.
All of this takes time, as indicated in Figure 1, but we have found that these are the programs that stand the test of time. It may be frustrating for the audiologist when we know these groups should have hearing protection, but being patient can mean that many more individuals will experience hearing protection once these programs are in place and the group has taken ownership.
Catherine Palmer, PhD, is a professor in the Departments of Communication Science and Disorders and Otolaryngology at the University of Pittsburgh and serves as the Director of Audiology for the UPMC Integrated Health System. Dr Palmer conducts research on the relationship between hearing, cognitive health, and health outcomes, and matching technology to individual needs. She has published over 150 articles and book chapters in these topic areas as well as provided over 200 national and international presentations. Palmer serves as editor-in-chief of Seminars in Hearing. She is a past president of the American Academy of Audiology.
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