Noise-induced Hearing loss in Dentists

Hearing Noise or Useful Listening?

Rebecca K. Horton, RDA

In the dental office, we are bombarded by noise all day long.  Did you ever stop to think how tired this makes you at the end of the day?

What if you could hear what you need to hear without all the distraction and exhaustion of that ceaseless, noisy racket?

What if instead of getting annoyed before lunch because you had a crying child patient, or kids in the reception area talking loudly, or doorbells, ringing phones, equipment in a ceaseless din, you had the serenity of speaking quietly to the patient you are working on and to the assistant you are working with?  Would that make a difference in your life?

I can remember when we installed Theta Systems’ color-coded call system so we wouldn’t be yelling at each other.  We would simply push the colored button and that person would appear.  Right?  Yes.  And then there were times when we all abused that system.  We’d lay down on that buzzer because we were already stressed out by 9:30 AM.  The day goes downhill from there.  You buzzed in an aggressive fashion, then the person responding caught your stress, then stress multiplied like Gremlins who ate after midnight


So all day long the stress breeds more stress until at the end of the day when you should be celebrating making it through the day successfully, you are so pissed off you can’t think straight. 

What do you have to lose?  What do you have to gain?  Is it possible to not be exhausted at the end of the day?  Or, if you’re tired, why can’t it be a good tired? Why would you not move mountains to gain control of this situation that repeats itself day in and day out in dental offices around the world?

The solution does not cost much.  How much does it cost to be exhausted and angry instead of peaceful and happy?

How Transducers Work in Ear Monitors

Let’s talk transducers! for those of you who know what they are your ears will perk up, but for those of you who do not know what they are  I might as well be talking about solutions to the motion of the free asymmetric top or Göbekli Tepli, but if I do my job right then both the transducer savvy and the transducer newbies can leave here with more knowledge. So, where do we begin?


What are the transducers?  Look closely they are these little metal blocks.

I believe that eating the frog and jumping into the murky details of what a transducer does and how it functions in a very simple way is a great way to dissect this topic (Pun intended). The term transducer in its base form means the conversion of an energy signal into another energy form. Simple enough right? One signal (The Input)  takes in an electrical signal and relays that message to an output such as a radio outputting sound, or a machine such as this  STANLEY right angle torque tool. In the in-ear monitor niche, the transducers job is to in the words of to, “convert the electrical signal into a sound wave that the ear can understand. Its straightforward and over the years many companies have crafted higher and higher quality devices that fulfill the needs of many different applications. And within these applications are the different versions of drivers available and they are a balanced armature, Dynamic, Planar magnetic, Electrostatic, Magnetostriction, or bone conduction transducers.

With this many choices, it is hard to go wrong with the transducer that you purchase, However, not all headphone drivers are created equal, and each specific type serves its purpose, read this article to understand which is right for your intended application. In our companies niche, we have selected balanced armature drivers as they are ideal for fitting within a custom shell and provide users on motorcycles, and users who intend using their in-ear headphones for communication in extremely loud surroundings exceptional clarity while efficiently producing sound waves which ensure that the user can have beautiful sound while listening  at  responsible volume levels. And this is an important point to be made as there are many options on the market and so many companies including ourselves that market and sell products with transducers in them. There are so many now that it can be hard to differentiate between what product you specifically need, and since I am writing this for both experienced and inexperienced transducer crowds.

I believe there are some myths to dispell before we go any further. The first is that there is a correlation between the number of transducers and the sound quality. While this is a true statement in most cases if the unit is a well-built device that showcases quality frequency responses and linear dynamics and meets professional standards only when this is achieved will adding more transducers to the equation output a higher quality sound. But if the build of the device is subpar and done in a non-professional manner with uncertified technicians the sound reproduction is degraded quickly, and the finished product may offer more drivers at a lower cost but when compared to a well built lower transducer count, the lower count higher quality transducer will perform much better.

Here ia a perfect example for you to understand Frequency. Our transducers we use to give you a response from 20HZ to 20,000. Get a listen to what that actually is. Set your speaker system to 3/4 volume. This is not a pretty test and it may even annoy some, but when people make recording either books on tape or music this is the frequency range that is used. When we design our head Stereo earplugs we take into account first what the frequency that is present, (say wind noise on a motorcycle) and designs a headset that will compensate for the outside sound and makes us totally different than any other company out there. Their units are designed in a quiet setting with no background noise. That’s why when you hear it just in a room then try and use it in an application they ALL fall short.

Get a listen at 3/4 volume to understand what frequency is.

The next myth to dispell is that name brand headphones are the highest quality products that you can buy. In the world of sales and marketing, the biggest fish dominate the industry and while this is fair, what does suffer at times is the end consumer as they are constantly being conditioned to purchase the most name recognized brand.  The problem with doing this in the headphone industry is that it can wind up costing you a lot of money very quickly for a subpar product that has massive marketing forces pumping out ads and product placements.

Big Box

How can I find a set that is personally made for me?

This is a very small niche that the Big Box players can’t service as everything is custom and one off. They try and make it seem that using a generic ear cup or a heat and stuff will do the trick as it is the easiest to manufacture.

However for the few who decide to look past the veil of advertising, there are many articles written that compare the performance of both well known and unknown in-ear monitors and even more youtube videos than you could ever watch in a lifetime that break down every aspect of headphones, earbuds, speakers and transducers and what they can do for you. And for those who do their research and invest in the right product, you can limit the money you spend while searching for the right product while also supporting non-name brand products.

The last two myths that I would like to dispell are. First, all custom earplugs are the same and second that all custom transducer products are too expensive. These two can be dispelled by just typing in,”Are custom earbuds worth it?” Into Google. What you will find are cases where journalists take the plunge into custom earbuds to uncover how good they are. And the dynamic range of choices that each journalist or enthusiast has defeats the first myth. Dispelling the second part of the myth that custom headphones are all too expensive is why I am writing this article. The problem that I see permeated in other articles covering custom products is in many reviews; the journalists acquire the biggest baddest and most expensive products from the most established and well-known custom headphone companies. They get the ten drivers or the eight drivers and laud the performance of the device.

This in the world of cinematography is like getting ahold of a red epic or an Arri Alexa and stating that it’s amazing, its a known thing that is tried and true. However what happens is the journalist does the article on the ten thousand dollar product, and as an afterthought, they throw in that you can get an affordable product at the four hundred dollar price point and they end the article without going into any more detail. In our consumer-centric society, this is dangerous as it creates an air of false superiority around custom headsets in that they are lavish and only for the mega-wealthy or the world-class musician who has just signed a huge record deal. But that is not the case.

In our product line and most other companies, there are extremely available options that don’t cost as much as a downpayment on a home. From our Be-1c that retails at 350.00 or our Be-2 which provides pro-level sound quality at an affordable price of 550.00 or the myriad of other companies mid-tier priced products. These products are all but missed as they are not the flashy 5 or 10 driver’s that our marketplace has saturated. However, this would not be a productive post if I just stated the issues. The way that these products receive recognition and attention is like any other product or cause; it takes time and exposure to resonate with a broader audience. And hopefully, through articles like this one and the hundreds of others on the internet, customers can receive the correct information on the other options past generic earbuds.

Big Ear put a bow on it

Let’s wrap up what we learned.

I would like to wrap this up by sharing that the passion that custom companies have for creating these high-quality transducers. In most cases, you will deal with very honest and upstanding people who work hand in hand with some of the best labs in the world to create products that will provide their customers with the very best in both hearing production and sound recreation. And by doing business with these upstanding businesses you will cultivate a market that keeps everybody who sells these products on their toes and constantly innovating to create the very best products, and in turn, you create a truly fair marketplace.

Tinnitus and noise-induced hearing loss are at an all-time high in the dental profession. I took a step back to look at what happened. It can be said that the dental profession as a whole has contributed to better life experience for people in North America since the turn of the 20th century. They have made a concerted effort in education and prevention for overall mouth health in the US. Now It’s our turn to educate the dentist about their major health issue so they can do something for the next generation of Dental Professionals. It can be solved by simply wearing dental ear plugs. What follows is the five stages that contribute to large-scale changes regarding personal protection and preventative measures within our society.

1. Awareness:

Many factors have contributed to this catastrophic onset of Tinnitus and noise induced-hearing loss that we are seeing. I have poured over the research to understand the common issue causing this, and I have found it. We are not aware that the new lifestyle habits and the profession have completely devastated the normal hearing in the dentist profession.


Once a profession as a whole understands that there is a significant shift in the health of a group we go into research mode. We study, investigate and report on what we see. All the research supports that our lives have become much louder and the professions we choose can and will accelerate noise-Induced hearing loss and Tinnitus if we do nothing about it.


“The Red Pill.” Unfortunately like when the dental health profession introduced the little red pill way back when I was in grade school, it showed the plack and scum that was on my teeth even after I was given the opportunity to brush first. It was a very embarrassing, and it was an impactful day for a lot of us. I think that when we became aware that we all needed to brush better, it changed all of our lives. The issue with tinnitus that it is invisible and the only person who can see and feel our shame, embarrassment and regret are ourselves. It acts as our own little red pill that only we can hear, and we have Ringing in our ears and difficulty understanding the conversation at a noisy restaurant. Just like our grandparents and even my parents that had dentures, They looked normal, but underneath the surface, they had to come to grips that they had false teeth. There was no alternative back then, and it was all about educating the next generations to come to take better care of what we have and took for granted.

4. Solution:

The Dental Profession is unique as a practice. You have to engage with the patient fully, and you have to be able to fully communicate with your assistant and hear all the nuances of your equipment, and you need to protect your hearing. Until now all of this was not achievable. I have studied all that goes into the workplace and have created a solution to solve the next generation of hearing loss in dentists. I Call it “The One.” It is a Low profile clear, discrete patented dual filtered custom dental ear plugs that allows perfect conversation and communication, all the while adequately protecting your hearing. You have to save what you have left of your hearing and try and get the Tinnitus under control and not aggravate it as it will continue to get worse through repeat exposure to damaging decibels. So like the “Red Pill” Take action now.
Choosing the right ear plug.

5. Advocacy:

Once you have implemented dental ear plugs as a necessary action in your practices it’s time to educate future generations of dentists that like brushing their teeth it’s up to them to personally protect themselves. Once you have found the right solution that works for you, it’s up to you to spread the word and pay it forward to the next group as we already are dealing with the effects of doing nothing.

How is Spinning Class is Causing Noise-Induced Hearing Loss and Tinnitus? Waking up in the morning you feel it; you have everything set out ahead of time, your outfit is hanging on the outside of the closet, your balanced breakfast is in the fridge and your gym bag is at the front door. You grab your things jump in your car and feel your foot is a little heavier on the gas as you fell the nerves and excitement before today’s workout. You have planned to arrive 15 minutes ahead of the others to ensure that you get your chance at the new peloton at the front of the class. You go through the class and feel yourself breaking new ground and hitting your imagined wall. After the workout finishes, the sweat has pooled around the floor,  you are seeing double, your caloric counter reads that you just burned 700 calories a new personal record, but when you leave and sit on the bench in the locker room with your towel draped around your head, the only thing you notice is the ringing in your ears. Is it the workout doing this? No, you’ve done this workout hundreds of times before at home, and you’ve never experienced this before, could it be the music in the studio? You rush back to the room and try to talk to the instructor, but they still have the music on full blast, you have to shout to be heard and its still not enough. “Is this music too loud?” You scream over top of the rising vocals of pitbull saying he wants you. “What?” They reply, “The music in here is this too loud for us to listen too?” You ask “Oh come on, don’t mess with the mood in here is what makes this class so much fun, it’s a workout par-teeey!!!” they respond.

Spinning Class party

Spinning Class Party!

This response hits your gut, and you leave the room embarrassed and shamed. Outside the room, the glass walls shake with the reverberations of the music. This is the sad scenario at hundreds if not thousands of spinning studios around the country and the world. But why is this behavior acceptable? And is there anything that can be done about it? The answer sadly comes in many different forms. According to the IFA(International Fitness Association), there are standards for gyms that must be met which are set by OSHA, they state according to official documents,” At 85 dB the EPA standard for safe sound is 45 minutes. At 88 dB the EPA standard for safe sound is 23 minutes. EPA regards 91 dB as unsafe for any length of time over 11 minutes.”

This is the law, and according to the same article, the authors state that “gyms and classes including instructors who do not adhere to these guidelines leave themselves open to legal ramifications in the future as well as workmen’s compensation considerations as this subject becomes more widely understood. ” Explained in this article is the key to the solution of NIHL (Noise-Induced Hearing Loss) in the gym and most areas of our lives. The key that this article hits upon is most individuals or corporations do not understand how their hearing is being damaged and are attempting to educate themselves on how noise levels in their workout classes are affecting their instructors and students.

This is understandable but what does matter in conservation programs is the action behind the intent. And in workout facilities, there is evidence that not much has been done to remedy this. In countless articles such as Kirsten Cole’s Pix 11 article,”Loud music in spinning class linked to hearing damage concerns.” Cole states, “In 2015 PIX 11 used undercover cameras and a decibel meter, to see just how loud classes were at some of the most popular spin studios.” Cole further explains that “All four studios played at a near constant 100 decibels or more. Throughout the classes, all studios spiked to levels of 115 decibels, blowing the known safety levels from industry fitness groups and OSHA.” In a separate article by Lindsay Miller titled, “Can Super loud Workout Classes Permanently Damage Your Hearing? An Expert Weighs in.” In the article, Miller asked an instructor at LA-based workout studio The Wall about any concerns she had. The instructor replied, “I’ve listened to loud music all my life. And I have noticed my ears ringing time and again. To myself, I always say ‘I’m losing my hearing!” And I still pump it up more.” In response to the same question, a colleague of the same trainer stated,”Music is a huge part of being an instructor,

Ears ringing after spinning class

Why are my ears ringing?

I worry much less about if it’s loud and more on if it makes people want to move.” Is it wrong to feel this way? To understand the risks of something and still do it anyway? Is Spinning Class is causing Noise-induced Hearing loss and Tinnitus? An argument can be made for both sides. But the idea of this article is not to judge and shame gyms and trainers on the noise levels in their workout classes and their business practices, this is written to spotlight a major problem within an institution and allow those within the institution make the decision to solve the problem internally before it is done for them by government agencies or any outside influences. By tracking data back to over 20 years ago, there is sufficient evidence to support the claim that sound within exercise classes is increasing at an alarming rate. In an article published in 2013by Elizabeth Francis Beach and Valerie Nie, titled, “Noise Levels in Fitness Classes Are Still Too High: Evidence From 1997-1998 and 2009-2011” The authors who “assessed noise levels during 35 low-intensity and 65 high-intensity fitness classes in 1997-1998 and 2009-2011″ and asked the participates to fill out questionnaires about the music levels in the room and if they found loud music to be,”Stressful, or motivating.” What they found was alarming. Their journal abstract states that, “Noise levels in 1997-1998 and 2009-2011 were similar, frequently exceeding 90 dB(A).” The article continues by stating, “Although noise levels in low-intensity classes dropped from 88.9 to 85.6 dB(A), they remained high for high-intensity classes averaging 93.1 dB(A).In 2009-2011 instructors preferred significantly higher volumes than clients for high-intensity classes.” The authors then explain that”In both time periods about 85 % of instructors found loud music motivating, whereas about one-fifth of clients found it stressful.”

This data is extremely crucial in understanding the reason why music in exercise classes is increasing and more importantly in what kind of classes the music is increasing in. This article defeats the notion that all exercise classes are the same. However, the truth is that a class dedicated to relaxing or rehab yoga will have lower music levels when compared to a spinning class or a CrossFit class. This delineation of high-intensity classes from low- intensity is important because the high-intensity classes are becoming extremely popular in our culture. Stemming from the cross-fit revolution new classes such as versaclimber, intense spinning classes, WOD, Trampolining, and combat based fitness programs all of which music plays a pivotal factor in the intensity of the workout, the volume is only going higher and higher.

Spinning Class Hearing loss data

Know the Hearing risks of your daily life

The data found by Beach and Nie and the data found from PIX 11 in 2015 shows that the decibel exposure is only increasing. So what can be done? One of the biggest steps to solving complex human habits is to first identify the issue, that is what the articles and journals quoted above serve to do. The next step is to attempt to reset or reprogram participants and instructors habits when it comes to their workouts. And in certain cases, there is headway being made. In Vicky Hallett’s 2015 article titled, ” If you think the music at your gym is too loud, that’s because it probably is” the author describes the atmosphere of a popular workout location and states,”These days, however, you’d be lucky simply finding a fitness facility that has a noise policy of any kind.” The article quotes Teri Bothwell a group fitness director of sport and health as she states,”Booming bass may be bad for your ears, but it’s good for business.” She continues by stating, “At boutiques, it’s a party, and it’s loud, and that’s part of what people pay for.” So the contradiction remains, if its something that the people want, and there is an industry dedicated to providing what they want, is it wrong? Even though what the group wants is permanently damaging them does that make it wrong? These are questions for another time and another person to answer but by just simply knocking on the door of the ethical and moral grounds is enough to open the minds of those who are participating as trainers or clients.

There are methods that can reprogram and reshape the way that workout facilities and the individuals who run them and the participants who attend classes at them. The first is something already put into practice by one trainer as is stated by Vicky Hallets about a group Instructor Asuka Boutcher in Hallets Washington Posts article, “If you think the music at your gym is too loud, that’s because it probably is.” Boutcher is a group training instructor who works with large groups ranging into the hundreds and Hallets explains that “While she’s (Boutcher) willing to put her own hearing at risk, Boutcher recognizes that it’s not a laughing matter. That’s why she’s settled on the same solution Reid did: earplugs. There’s a big bucket of them available free for any student.” For an instructor to think about their students and provide them with hearing protection during a workout is a step in the right direction. The next step is recognition on the part of the students in these classes,

Hearing loss Hurdle

Overcome the social stigma of going against the norm

This may be one of the most difficult hurdles to overcome as there is not only a personal hurdle to overcome, there is a social issue where an individual must speak up and run the risk of being on the outside with their opinion within the fitness industry that can be a place of wonderful improvement but can also be fraught with industry backbiting and inter-gym competition and gossip. Lindsay Miller weighed in her article and gave insight into how she raised the issue when she experienced muffled hearing after a workout. Miller states that “Maybe I was being too sensitive. Maybe I just had a knack for booking exceptionally loud classes and instructors. So, a few days after that fateful Spin class, I decided to informally poll my Facebook friends.” She continues by stating,”Had any of them either walked out of a workout class because the music was too loud or been legitimately concerned that the volume in a workout class was negatively impacting their hearing? Fifty-four percent of the people who responded said yes.” Actions such as these are what power change.

The number of people who responded to her poll is not given, however what her data does show is the recognition of a glaring problem within a very hush-hush type of atmosphere that at times promotes pain as weakness and having the ability to push yourself through extreme mental, emotional, and physical pain to reach your goals as a sign of strength and positivity, and while these traits will result in a better physique, they can also lead to permanent damage. And this is the mindset that works for and against the participants and instructors. In our ideal gym environment  instructors are making earplugs available for their students, the students are monitoring their own ear health and limits and acting accordingly by either protecting themselves or speaking up about the issue, the next question is how do we make lasting changes to these environments that promote the overall health of all of the participants?

Hearing loss Regulators

It’s just Spinning class for god’s sake

Is it sweeping regulations forced on every gym in the nation? Is it drastic changes to the business practices of each individual gym, health club, rehabilitation facility, physical fitness service, or the hundreds of other names that these clubs fall under? Is it a state by state, county by county, block by block reform of every institution that plays music in their gym environment? That is what Aaron D. Werner and his article in, “The National Law Review” titled, “Compliance with Health and Fitness State Laws:Background, Best Practices and Key Takeaways for  Health and Fitness Club Owners” In the article Werner attempts to give gym owners the proper tools to set up a healthy and responsible club that will allow them to practice safe and responsible ownership and contribute to a positive atmosphere. He does state at the top of the article that, “The problem is the difficulty in obtaining complete and accurate information regarding which laws are applicable to their business.” And this is the circle that we repeat as there is as of the time of writing this article in 2018, very little precedence within the united states legal system that holds gym owners, instructors, and students accountable for their actions. This does not mean that noise levels in workout facilities will remain the same, what it does mean is that there is room for growth and because we are becoming more self-aware about our health, we can always learn more and protect ourselves accordingly including legislation and sweeping legalities that maximum decibel exposure at a given time while engaged in an exercise class. But until that day does come it falls on the individual to educate themselves on the risks, and on governmental and industry-leading brands to promote safe and healthy workout environments for the overall long-term health of their members and most importantly it falls on the shoulders of those in positions of influence to set positive examples for younger generations to learn from and as we learn and adjust our habits we then have the possibility of exacting a positive change in our future.

Spinning Class is causing Noise-induced Hearing loss

Hearing Loss is not a benefit of spinning Class

Further Reading

If you found the above reading interesting, check out the following articles to learn more.

 How to chose the best hearing protection for shooting

Here is an article on what the buying cycle is for stoping Hearing Loss.

Specialized protection for Spinning loss to stop: Spinning Class is Causing Noise-Induced Hearing Loss and Tinnitus.

See The One


Big Ears is a dynamic festival experience in downtown Knoxville, TN.  It explores connections between musicians and artists, crossing all genres. It is the responsibility of the attendees to preserve there hearing when attending any event. The Big Ears Music festival.

Loving My Big Ears at the big ears music festival

Loving My Big Ears


How to chose the right earplugs article will explain how to best protect your hearing and how to find a provider to get you the best set of Big Ear’s you have ever had.

Declared “one of the most quietly earth-shattering, subtly luminous festivals the world over” by The Oxford American Magazine, Big Ears Festival is a dynamic, interactive experience that explores connections between musicians and artists, crossing all musical genres while interfacing with film, performance and the visual arts.

So when attending you need to get a custom set of Big Ear’s Musicians Earplugs. This will allow you to hear everything perfectly while being able to enjoy the music for years to come.

This is Knoxville Tennesee in a nutshell:

First settled in 1786, Knoxville was the first capital of Tennessee. The city struggled with geographic isolation throughout the early 19th century. The arrival of the railroad in 1855 led to an economic boom.[16] During the Civil War, the city was bitterly divided over the secession issue and was occupied alternately by both Confederate and Union armies.[16] Following the war, Knoxville grew rapidly as a major wholesaling and manufacturing center. The city’s economy stagnated after the 1920s as the manufacturing sector collapsed, the downtown area declined and city leaders became entrenched in highly partisan political fights.[16] Hosting the 1982 World’s Fair helped reinvigorate the city,[16] and revitalization initiatives by city leaders and private developers have had major successes in spurring growth in the city, especially the downtown area.[17]

So what better place to have the Big Ears Music Festival.

The testimonials of people who love their Big Ears