Why are “The One” Earplugs the Best Dental Earplugs?

Dental earplugs present a problem. How can a dentist hear everything they need to hear, all while protecting from tinnitus and hearing loss caused by loud noises?

Best Dental Earplugs

The One is the only hearing protection on the market that allows dentists to hear everything around them and clearly hear others while protecting their hearing. This “spatial awareness” is not available with any other dental hearing protection.  The One® for Dentists is the new industry standard. It is simply the Best Dental Earplug

After working with dentists from across the nation, we realized that they were unaware of the loud noise exposure that they are subject to every day. Whether the sound is from handpieces, pumps, or scalers, dentists hear dangerously loud noises daily. The proper steps toward protection are not always taken despite the severe effect that these sounds have on dentists’ hearing.

Other generic, one-size-fits-all products claim that they protect the hearing of dentistry professionals. This claim is only accurate if those earplugs were worn in the office without discomfort. However, they clearly cannot and do not because they give the dentist a blocked or “clogged” feeling in their ears outside of treating patients. Generic products do not all the dentist to hear both their equipment and other people in the office. This is because they plug the ear canal. They also also only mask, match, or recreate the sound around the ear without having the desired effect.

We’ve experienced this before with professional musicians.  They think they are protecting themselves from damage while rehearsing and playing. The musicians, often with very high-quality earplugs, and especially those with generic earplugs, developed tinnitus. Their hearing weakened. Their playing ability worsened. The musicians’ conductors had to either retire the players or move them down in rank as a result of the hearing damage. 

The same can be said for dentists: they must hear every tool and sound from their patient. They also must communicate with coworkers and technicians. Most importantly, they must not lose their hearing. They and their clinic will suffer reputational damage if this happens. In most cases, dentists stop wearing hearing protection altogether due to discomfort. This causes permanent hearing loss and tinnitus.

Custom Filtered Hearing Protection Explained

This is where The One comes into play. It has a dual-filtered hearing protection system that both protects your hearing and allows you to hear everything around you. Our product is superior to all others. The primary filter provides a flat noise reduction through all frequencies. It works as a screen door that allows sounds of a certain decibel to clear a reduction filter. This includes 9, 15, 20 and 25-decibel options.

The secondary, non-linear filter allows sounds under 85 decibels to pass through. This enables dentists to hear clearly and not experience the “clogged” feeling that other earplugs frequently cause. The secondary filter also acts as a vent. It equalizes pressure between the inside and outside of the ear.

The result is that the dentist hears clearly at work while operating and interacting with patients. They feel like they have nothing in the way of their hearing. Most importantly, they protect their ears at the same time.

We make the Best Dental Earplugs with a set of impressions of one’s ear. We found that the process of making earplugs is easy for dentists because they have experience making impressions of teeth. It is a fun little diversion to make impressions at the office or at home.

If and when you order the plugs, you receive our Big Ear home impression kit. You can make impressions for everyone in the office after following the instructions of a very short video. Once we have the impressions back, it usually takes 21 business days from the date of arrival of the impressions to complete the production. Rush service is also available at an additional charge. The earplugs come in several colors as well as in an less obvious option. Most patients do not notice the earplugs. 

We created the Best Dental Earplugs to stop the insanity of dental hearing loss. They also make the lifestyles of dentists more comfortable. Finally, the earplugs make dentistry less damaging to lifetime health.

Our guiding purpose is to protect your hearing and the hearing of those in your practice. This lets you provide your patients with the best version of yourself and also ensures that they get the care they need.

Glenn Hood

Founder 

Big Ear

https://bigearinc.com/products/dentists/ 

How to choose the best Hearing Protection

The One Hearing Protection: Guaranteed Tinnitus and Hearing Loss Prevention

Often, dentists receive physical consequences from their own practices. In addition to minor hand injuries and torn muscles from operating on teeth, dentists experience continuous exposure to unhealthily loud noises. The sources of the noise they experience originate from the tools they work with and the environment they work in on a daily basis. Tools like the hand-pieces dentists use generate a lot of noise. With continued exposure, dentists risk hearing loss. The number of dental professionals who have noise-induced hearing loss and tinnitus grows every year. There is a solution to this: The One dental earplug.

Tinnitus In Dentists

The One is a customized earplug designed specifically for dentists. These earplugs prevent exposure of the ear to excessive noise from both the machines and the natural environment of dentistry operations. The One functions with two filters. There is the primary filter on the outside and the secondary filter in the inside. The primary filter filters general noise from the environment and machines. The secondary filter filters the unwanted noise.

Importance of Using The One Dental Earplug

The major difference between The One dental earplug and any other form of filtered or vented earplug is that our earplug allows for a specific limit of noise exposure. The two filters work simultaneously, thereby controlling the type of noise that ends up in the inner ear.

The secondary filter ensures only the natural voices access the inner ear. Additionally, it only allows up to 85 dB of sound. This implies that only the allowed noise pressure can penetrate the earplug. As for The One dental earplug, the allowed noise includes natural sounds such as of the patient and the surgery crew. This earplug pinches off sound pressure that can damage the sensitive inner ear sensory hairs.

Also, the dental earplug regulates the intensity of the noise that reaches the inner ear. This standardized feature does not discriminate between noise sources. Therefore, even if the noise comes from the natural source, the secondary filter will filter it out. For instance, the earplug cancels noise from the turbines of high pitched hand drills that would otherwise dose the dental professional with noise pressures exceeding 85 decibels. On the other hand, the earplug allows any other natural sound with pressure below 85 decibels into the eardrum. 

Tinnitus In Dentists, a risk associated with loud noise exposure

According to a study by the Centers for Disease Control and Prevention, more than 5 out of 10 retired dentists experience tinnitus. In the same study, the CDC discovered that only a third of the people suffering from tinnitus seek medical assistance, which can prove quite expensive. With this already expensive medication, only two out of five tinnitus patients successfully recover using this medication while the rest remain in an irreversible state.

Patients with tinnitus hear a constant ringing that is not experienced by others. Currently, there is no cure for tinnitus. Tinnitus prevention using our earplugs is much cheaper and much more successful.

How Tinnitus In Dentists develops

Several factors cause tinnitus in dentists. However, the major cause is prolonged exposure to of the ear to sound that exceeds 85 dB. This exposure leads to inner ear hair cell damage. Exposing an ear to high-intensity sound causes the delicate inner ear hairs to move in the direction of the sound waves. This triggers the ear cells to produce an electrical signal through the auditory nerve to the brain. The signals sent to the brain translate the waves into sound. In cases where the inner hairs in the inner ear break or bend, the result is a random electrical signal sent to the brain that results in the vast array of sounds that individuals with tinnitus hear.

Tinnitus In Dentists symptoms

The main symptom of tinnitus is the hearing of imaginary sounds not actually present in the environment. Some of the phantom noises associated with tinnitus include the following:

    • A ringing sound, which may become louder or lighter with time.
    • A frequent buzzing sound 
  • A roaring sound.
  • A hissing sound

These sounds may occur in one or both ears. In some cases, the noise may become so loud that it interferes with a person’s concentration. The sound may be irritating, hindering afflicted people from hearing actual sounds in their environment.

Causes of Tinnitus In Dentists

  • Exposure to loud noise

Noisy equipment such as dentists‘ hand-pieces can cause tinnitus. Such equipment produces excess levels of noise to the ear. Continuous use of the same equipment by the same dentist without adequate hearing protection puts them in greater danger of developing tinnitus. 

Other causes

  • Age-related causes

As a person ages, they become vulnerable to presbycusis. Such a condition occurs when a person nears the age of 60. The more a person exposes themselves to damaging sounds, the more that person experiences ear damage and a higher potential of developing tinnitus. 

  • Earwax blockage

Earwax protects the ear canal by trapping dirt and other foreign substances, preventing them from entering the inner ear. Ear Wax also prevents bacterial development in the ear. However, when earwax over-accumulates in the ear canal, it may cause ear loss or irritation in the ear canal, which can cause tinnitus. 

Tinnitus causes for dentists

Several scientists have hypothesized different possible causes of tinnitus. Some relate tinnitus to head injuries, acoustic neuroma, blood vessel disorders, and medications like antibiotics and aspirin. In all their arguments, scientists appreciate that the major legitimate cause of tinnitus in dentists is exposure to noise. 

The nature of the working environments of dentists ensures that they cannot avoid exposure to noise without leaving their office. They continuously expose their ears to excessive noise from the equipment they use and in their normal exposure to sounds in their environment. The materials in their laboratories produce a high volume of noise. When exposed to this noise for long periods of time, tinnitus may be triggered, hindering dentists’ performance.

Complications that come with tinnitus

Tinnitus affects every person differently. According to research by the Department of Health and Human Services, a person suffering from tinnitus may experience the following complications:

a. Fatigue

People with tinnitus experience frequent fatigue and may feel unmotivated to complete even the slightest of household chores.

b. Stress can develop from the worry caused by tinnitus. Continued stress will develop into depression. 

c. Sleeping problems

d. Difficulty concentrating

e. Irritability

f. Depression 

General tinnitus preventive measures
  •  Long-term exposure to loud music through headphones can increase an individual’s chances of developing tinnitus. For music listeners, reducing music volume may help reduce chances of tinnitus. However, this preventive measure fails to apply to dentists. They cannot turn down the volume of noise produced by their machines. But they can reduce exposure to noises outside their offices through strict dedication to protecting their hearing. This includes limiting their exposure to sounds that are within their control.
  • Tinnitus can be prevented by routinely taking care of cardiovascular health. Prevention of blood disorder-linked tinnitus achievable through a healthy diet and regular exercise.
  • Dental professionals who have hobbies that are loud, like motorcycle-riding, listening to loud music or spending hours outdoors may find themselves at greater risk. Limiting exposure to sounds over 85 decibels while partaking in these hobbies will reduce the risk dentists being dosed by dangerous decibels outside of the office.

Protecting yourself as a dental professional may seem like a lot of work. It is, however, protection can ensure that you continue working into your golden years. It is imperative that you develop an individualized hearing conservation solution that works for you, whether that includes wearing hearing protection in and outside the office, or if you prefer to wear hearing protection in the office and monitor exposure to sound during recreational activities.

As a last reminder, both to dentists and all people, we leave you with this: tinnitus is permanent until death. Once you develop tinnitus, you cannot repair it. So act accordingly. And choose the best hearing protection.

Premium Earplugs for Dentists – NIHL and Tinnitus is a Dental Hazard

Premium Earplugs for Dentists

How important is your hearing to you?  Hearing protection for dentists, dental assistants as well as dental hygienists is very crucial. The most common hearing hazards are high-speed dental drills, ultrasonic cleaners, and high-speed turbine hand-pieces. Unfortunately, most dental professionals do not notice how noise-causing equipment is affecting them until it is too late. Fortunately, there are premium earplugs that offer excellent hearing protection for dentists.

In case dentists are not wearing hearing protection while working, they could cause themselves and those around them irreversible hearing damage. Unfortunately, this could lead to lifelong pain, discomfort, and the worst of all a shorter career. When considering the hearing protection, dentists have specific needs:

The greatest amount of noise blocking without overprotecting  

For dental professionals hearing protection that protects them from higher pitch frequencies such as the 2kHz to 6kHz frequencies are essential. Yet overcompensating for high pitch frequencies can lead to overprotection and can be dangerous for both the dentist and their patients.

Natural hearing:

The best dentist earplugs should enable the dentist to hear clearly and interact with their patients without feeling plugged up. The earplugs do not have to be removed when holding a conversation.

Indiscrete appearance:

It may seem unappealing wearing earplugs in an office set up. However, dentists’ earplugs feature a low-profile fit that will ensure you do not damage your hearing, and your clients do not feel alienated while you operate and interact with them.

These are the primary reasons why we created The One series for dental use.

This product was released by Big Ear, a company that deals with products proving custom hearing protection. It was aimed at preventing dentists from enduring low-level noise which affects hearing. They could, at the same time, hear patients and workmates during the entire day.

Over the past few years, the dental industry has seen an increase in dentists developing tinnitus and eventually hearing loss. This is due to the noisy equipment used in dental clinics, which could put them at risk. The earplug, therefore, allows dentists to get rid of noise while communicating very well.

The customized Premium Earplugs for Dentists is basically worn by dentists while working with patients. The dentist will hear the patient clearly as well as others in the room. You could probably ask yourself, is there any difference between the One Series and other professional earplugs? The reality is the One Series is lighter and does not hinder any communication with a patient or colleague.

Premium Earplugs for Dentists

Premium Earplugs for Dentists

The One Premium Series, With all the bells and whistles. Included are 4 sets of filters, one set of filter blocks, one tactical piece, and the filtered earplugs.

How does the earplug prevent hearing loss?

It basically works using two filters. Firstly, the primary filter reduces the sound from entering the device. On the other hand, the second filter allows natural sound to pass through the dental earplugs. Additionally, the second filter enables the wearer to hear natural sounds until the noise pressure of 85 dB is achieved. Surprisingly, once this figure is achieved, the pressure cannot pass through the earplug. As a result, the hearing protection for the dentist is achieved.

Dentists in the course of their work experience natural and unnatural noises which may eventually damage the hearing process. Therefore custom Premium Earplugs for Dentists help get rid of unwanted sounds. The One Series earplug has some unique features. It is comprised of four sets of filters as follows: one set of silicon full stop earplugs, one set of non-linear plugs, a tactical piece to be used for your office communication, a lanyard and premium case.

You may think of using other generic or even custom earplugs that are stated to be for dentists. Unfortunately, they give you an uncomfortable feeling when worn. Instead of hearing protection, they hinder the dentist from hearing the equipment. They can hardly hear other people in the office.

Pros

  • It fills the ear canal.
  • It is small and not bulky.
  • It is comfortable while wearing.
  • It is inexpensive.

Cons

  • It is not washable; dirty or waxy it has to be thrown away.
  • If not correctly inserted, the amount of attenuation is limited.
  • Not properly maintained, it can insert dirt into the ear and cause infection.

Bottom line

Our ears play a significant role in our lives. Therefore protecting the ears from the disturbing noises is very crucial. This will lead to an effective hearing, thereby preventing the chances of developing tinnitus. Unfortunately, most dental practitioners develop it over time while being unaware. The One Series earplug helps to protect the ear against damage, which could limit a dentist career.

How to find the best Premium Earplugs for Dentists

Dentist Hearing Protection and How PROTECTED  Is Your Dentist?

Dentist Hearing Protection

I have spent more than $20,000.00 at the dentist office and have been berated because I don’t floss enough, brush in the right motion and brush too hard. I have bee counseled on the effects of harsh toothpaste and the negative effects of drinking too much tea or coffee and the negative consequence of long-term improper dental care.

It is something that I really pride myself on and I am unashamed to take 5 minutes before dinner or in the middle of the day and brush my teeth. It’s just something that I’ve built into my lifestyle and I have developed positive habits around my oral care. And it is now something that I do not consciously think about.

I can parallel the argument of dentists pleading with their patients to take care of their oral as my life’s work relies on my ability to convince others to protect their hearing and although the risk of losing your hearing is less of a risk factor than losing your oral health and the myriad of fatal diseases that come with poor dental hygiene, the quality of an individuals life decreases substantially the more hearing damage they have.

Recently a  dentist called me out of the blue and wanted Dentist Hearing Protection, and after discussing why he was interested in earplugs he explained that he was experiencing hearing loss and started getting ringing in his ears. This shocked me as I’m in the hearing protection business and have personally talked with more than a million and a half people at more than 5oo events and we service some of the largest companies in the world and protect the hearing of their workforce.

It never dawned on me that my local dentist is in an equal amount of danger as employees in industrial facilities. I started my research and discovered that they are in one of the most hazardous businesses of all. On average in the dental profession, 37% suffer from Tinnitus and over 50% (I need the source for these numbers)  suffer from noise-induced hearing loss rates. After collecting the data and uncovering this new information I did what I felt was the right thing and called OSHA. 

With all the public domain research in the world, I was taken back with what they said, “Why would a dentist need Dentist Hearing Protection?” I was floored as it is as simple as one Google search to find, page after page of studies pertaining to dentists and hearing loss. (Once again I need your sources) We are in a different time now, we have so much imperial data and it seems as if every major issue is simply another one for the pile to get to at a later date.

I’m grateful for dentists, and they have now added Dentist Hearing Protection to my list of industries that I will serve and spread the message of hearing conservation too. After this shocking but enlightening turn of events, I realized that the custom hearing protection product that I just patented would be the exact solution for the dental profession because of their individual needs. In the dental profession, it is necessary that They look sharp, hear everything around them perfectly, including their assistant and be adequately protected against the persistent decibels that they are exposed to every day. Furthermore, they are also exposed to an array of chemicals that cause many other health issues and even some of them make hearing loss worse.

If this article has piqued your interest please feel free to reach out to me at 719-271-9081 or find more information here and tell your dentist that he needs to protect his hearing.

https://bigearinc.com/products/dentists/

How to choose the best hearing protection

Integration of Dentistry and the One, a Guarantee to Tinnitus and Hearing Loss Prevention

Over the course of the years, dentists have been on the receiving end of  Tinnitus and hearing loss consequences emanating from their own practice. Apart from minor hand injuries and torn muscles operating on teeth, they experience continuous exposure to noise pollution. The sources of the noise they experience originate from the tools they use and from the natural environment. Some of the tools they use such as the handpieces generate too much noise which when the ear is exposed to for a long time, the dentist risks hearing loss. From the natural environment, the ear picks noise from the cries by the clients or from the people in the room during surgery. Without dentists, some of our toothache problems may lack an amicable solution, tooth alignment may stall and tooth removal cease. If the dentists are such a blessing to us, why do they go down the victims of tinnitus and hearing loss?

The One dental earplug

The One is a customized earplug specifically designed for the dentists. These earplugs prevent exposure of the ear to excessive noise from both the machines and the natural environment during operations. The One functions with two filters. There is the primary filter on the outside and the secondary filter in the inside. The primary filter filters general noise from the environment and machines. The secondary filter filters the unwanted noise before it reaches the eardrum.

The One Premium Series, With all the bells and whistles. Included are 4 sets of filters, one set of filter blocks, one tactical piece, and the filtered earplugs. to prevent tinnitus and hearing loss

The One Premium Series, With all the bells and whistles. Included are 4 sets of filters, one set of filter blocks, one tactical piece, and the filtered earplugs.

Importance of using the One dental earplug

The major difference between the big Ears’ the One dental earplug is that it allows for a certain limit of noise exposure. The two filters work simultaneously thereby controlling the type of noise that ends up in the inner ear. From the outside of the ear, the primary filter regulates the amount of noise entering the earplug from both the natural environment and the dental surgery equipment. Unlike other earplugs with a single filter, the One dental earplug has two to filters which collectively work together to regulate the amount of noise entering the inner ear.

On the second filter, the One dental earplug has the secondary filter installed. The secondary filter ensures only the natural voices access the inner ear. Additionally, it only allows up to 85dB. This implies that only the allowed noise pressure can penetrate the earplug. As for the One dental earplug, the allowed noise include natural sounds such as of the patient and the surgery crew. This earplug bars other types of noises from reaching the inner ear.

In addition, the dental earplug regulates the intensity of the noise that penetrates to the inner ear. This standardized feature does not discriminate the source of the noise. Therefore, even if the noise comes from the natural source, the secondary filter will filter it out. For instance, the earplug cancels the noise from a patient that screams exposing the eardrum of the dentist to a noise pressure exceeding 85dB. On the other hand, the earplug allows any other natural sound with pressure below 85dB into the eardrum.

Big Ear custom Earplugs make my life bearable from tinnitus and hearing loss

The ringing in your ears stays with you 24/7. It’s like having a toothache forever.

Tinnitus and hearing loss, a risk associated with loud noise exposure

According to the study by the Centers for Disease Control and Prevention, at least 5 out of 10 retired dentist experience tinnitus. In the same study, they discovered that a third of the people suffering from tinnitus seek medical assistance which proves quite expensive. Two out of five people suffering from tinnitus successfully recover using this medication whilst the rest remain in the irreversible state. In cases of tinnitus irreversibility, the dentist risks permanent ear loss.

Tinnitus refers to the perception of a type of a ringing sound by a person whereas the sound is non-existent. Over the course of the years, scientists have tried explaining what really causes tinnitus and what the potential treatment may be. In as much as they cannot precisely deduct the cure for tinnitus, they relate treatment by studying the causes. They relate tinnitus and hearing loss to the related illnesses and understanding the symptoms to help ease, manage or block out the ringing-in-the-ear sensation.

How tinnitus develop

There are several factors preempted to cause tinnitus. However, the major cause is prolonged exposure to of the ear to intensive noise. This exposure leads to the inner ear cell damage. Exposing an ear to high-intensity sound causes the inner delicate hairs to move in the direction of the sound waves. This triggers the ear cells to produce an electrical signal through the auditory nerve to the brain. The signals sent to the brain translates into sound. In cases where the inner hairs in the inner ear break or bend, a random electrical signal sent to the brain cause tinnitus and hearing loss.

Tinnitus symptoms

The main symptom of tinnitus is the ability to hear imaginary sounds when there is no actual sound in the environment. Some of the phantom noises from the ear associated with tinnitus include the following:

  1. A ringing sound, which may become louder or lighter with time.
  2. A frequent buzzing sound
  3. A roaring sound.
  4. A hissing sound

These sounds may occur in one or both ears. In some cases, the noise may become so loud that it interferes with a person’s concentration. The sound may be irritating hindering a person from hearing the actual sounds in the environment.

Causes of tinnitus

  1. Exposure to loud noise

This is the major cause of tinnitus. Continuous exposure to loud noise increases chances of the inner hair of the ear-bending or breaking. When the hair breaks, it triggers the auditory nerve to send irregular electrical signals to the brain triggering tinnitus. The dentists while performing their tooth surgeries, they use noisy equipment such as the handpieces. Such equipment produces a large volume of noise to the ear. Continuous use of the same equipment by the same dentist without an earplug exposes them to greater danger of developing tinnitus and hearing loss.

Other causes

  1. Age-related causes

As a person ages, they become vulnerable to presbycusis. Such a condition occurs when a person approaches the 60th age. The person tends to wear out in terms of their hearing capability. The more a person experiences ear loss, the higher the chances of developing tinnitus.

  1. Earwax blockage

Earwax protects the ear canal by trapping the dirt and preventing bacterial development in the ear. However, when the earwax over accumulates in the ear canal, it may cause ear loss or irritation in the ear canal which may cause tinnitus and hearing loss.

Tinnitus causes for dentists

Several scientists have hypothesized different possible causes of tinnitus. Some relate tinnitus to head injuries, acoustic neuroma, blood vessel disorders and other medications such as antibiotics and aspirin. In all their arguments, they appreciate that the major and legit cause of tinnitus in the dentist is exposure to noise.

Following the nature of the working environment the dentists, they cannot resist exposure to noise. Over the course of their carrier, they continuously expose their ears to excessive noise from both the materials, which they use and the patients themselves. The materials in their laboratories produce a high volume of noise, which may trigger tinnitus and hearing loss when exposed for long. Other sources of noise in the office are the natural cause. Natural causes include the noise from the surgery personnel and the patients.

Complications that come with tinnitus

Tinnitus affects a person wholesomely. The quality of life of the person deteriorates differently. According to a research by the department of health and human service, one may experience the following complications alongside tinnitus and hearing loss.

a. Fatigue

People with tinnitus and hearing loss experience frequent fatigue without a proper course. Others may feel lazy in handling even the slightest of house chores.

b. Stress, which develops due to continuous worries of the condition one, is in. Continued stress develops into depression.

c. Sleeping problems

d. Concentration issues

e. Irritability especially in the inner ear.

f. Depression arises with excessive worrying of the situation one is in.

General tinnitus preventive measures

  • Turn down the machine volume. Long-term exposure to loud music through headphones increases chances of developing tinnitus. For music listeners, reducing the music volume may help reduce chances of tinnitus infection. However, this preventive measure fails to apply to dentists. They cannot turn down the volume of noise produced by their machines.
  • Take care of cardiovascular health as a routine. Prevention of tinnitus and hearing loss linked to blood disorders is achievable through right diets, regular exercise and taking steps aimed at ensuring one attains a clean blood vessel. This preventive measure is applicable to the dentist. However, the tinnitus in dentists is not blood-linked.

Tinnitus and Hearing loss preventive measure for dentists

Using the Big Ear’s the One dental earplugs. As stated earlier, the One dental earplug is the one stop shop for a customized earplug for dentists. At Big Ear Earplug Company, thorough research on earplugs enhances production of the right kind of earplug any dentists would desire. The company ensures a dentist is comfortable in their earplugs, they provide after-purchase services where they trace the client’s progress. Finally, the earplug has two filters, the primary and the secondary filter. The primary filter prevents noise penetration from the environment whilst the secondary ensures only the natural noise such as of the patient penetrates to the inner ear of the dentist. Using the One dental earplug is the only safe way that guarantees a person total protection from tinnitus and hearing loss.