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Hearing aid domes: types, sizes and when to change them

Hearing aid domes are the soft silicone tips on the end of a receiver or thin tube that sit in your ear canal. Open, closed, power and tulip domes each seal the ear differently, which changes how natural sound feels and how much bass you hear. Your audiologist chooses the type to match your hearing.

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Written by the audiology team at Sutton Hearing Care

What does a hearing aid dome do?

If you wear a receiver-in-canal or slim-tube behind-the-ear hearing aid, the dome is the small flexible cap that sits just inside your ear canal. It has three jobs: it holds the speaker or tube in the right place, it directs sound towards the eardrum, and it controls how much of the ear canal is left open.

That last point matters more than most people realise. A dome that leaves the canal open lets natural sound in and out. A dome that blocks more of the canal keeps amplified sound in, which helps with greater hearing loss but can make your own voice sound different.

What are the main types of hearing aid dome?

Each manufacturer has its own names and shapes, but domes generally fall into four groups.

Dome type What it looks like Often suited to
Open A single layer with holes or vents Mild high-frequency hearing loss where low-pitched hearing is still good
Closed Fewer or smaller vents, a firmer seal Mild to moderate loss that also affects lower pitches
Power (double) Two layers, giving the firmest seal of the standard domes More significant hearing loss needing more bass and volume
Tulip Two overlapping petals that can be adjusted A middle ground between open and closed for some fittings

Open domes

Open domes feel light and airy. Your own voice usually sounds natural, and the ear does not feel blocked. Because sound can leak out, they are less suitable when you need a lot of amplification in the low pitches.

Closed domes

Closed domes keep more amplified sound in the ear, which can make speech fuller and help in noisy places. Some people notice their own voice sounds a little boomy at first. This usually settles as the brain adjusts.

Power domes

Power or double domes give a firmer seal so the hearing aid can deliver more volume without whistling. When a dome no longer gives enough seal, a custom earmould may be the next step.

Tulip domes

Tulip domes have two flexible petals. They can give a little more seal than an open dome while still letting some air through, and some wearers find them comfortable for long days.

How are hearing aid domes sized?

Domes come in several diameters, usually labelled by size in millimetres or as small, medium and large. Ear canals vary a lot, and many people need a different size in each ear. The right size feels snug enough to stay put but should not press, itch or ache.

Your audiologist checks the fit by looking in your ear and by testing how the aid performs once it is in place. At Sutton Hearing Care, real ear measurement at the fitting checks the sound reaching your eardrum, and the dome is part of that picture. If you change dome type or size, the hearing aid settings may need adjusting too, so it is best not to switch types on your own.

When should I change my hearing aid domes?

Domes are soft and wear out. A common recommendation is to change them every few months, but change them sooner if you notice any of these:

  • The dome looks yellow, discoloured or has wax stuck in the vents.
  • It has become stiff, cracked or split.
  • It has lost its shape or feels loose on the receiver.
  • Sound seems weaker or you have started to get whistling.

To change a dome, hold the receiver or tube firmly, pull the old dome straight off, then push the new one on until it sits fully over the ridge. Give it a gentle tug to make sure it is secure. A loose dome is more likely to come off in the ear.

If a dome is left in your ear. Do not try to remove it with tweezers, cotton buds or anything else, as you may push it deeper or scratch the ear canal. Contact your audiologist or GP practice for help. If you have pain, bleeding or discharge, see your GP.

How to make domes more comfortable

  • Insert the dome along the natural angle of the ear canal. Gently pulling the top of your ear up and back with the opposite hand can help.
  • If one ear feels sore, try a smaller size, but ask your audiologist first so the sound can be checked.
  • Itching can come from dry skin, wax or simply getting used to something in the ear. Persistent itching, redness or soreness should be checked.
  • Keep domes clean. Wax build-up can make them stiffer and less comfortable. Our guide on how to clean hearing aids includes a weekly routine.

Domes or custom earmoulds?

Domes are ready-made and quick to fit, which is why they are used with many modern hearing aids. A custom earmould is made from an impression of your ear. It can give a more secure fit and a better seal for greater hearing loss, for active people, or for ear canals that domes do not suit. Your audiologist can explain which is likely to work best for you.

Dome fitting and supplies in Sutton Coldfield

If your domes keep falling off, feel uncomfortable or your aids have started whistling, pop in to see us at Sutton Oak Road in Streetly. We can check the fit, look in your ears with video otoscopy and service your hearing aids, including most makes bought elsewhere through our hearing aid repairs service.

New to hearing aids? A free hearing test of up to 90 minutes is the place to start, with no GP referral needed. Call 0121 369 0780 or book online.

Common questions

What is the difference between open and closed hearing aid domes?

Open domes have vents that let natural sound in and out, so the ear feels unblocked. Closed domes give a firmer seal that keeps more amplified sound, especially bass, in the ear. Which suits you depends mainly on how much low-pitched hearing loss you have.

Can I change my dome type myself?

You can replace a dome with an identical one at home. Switching to a different type or size is best done with your audiologist, because it changes how sound reaches your eardrum and the hearing aid settings may need adjusting.

Why does my hearing aid dome keep coming off?

Usually the dome is worn, the wrong size, or was not pushed on fully. Replace it with a new dome and press it firmly over the ridge. If it keeps happening, ask your audiologist to check the receiver and the fit.

Are hearing aid domes universal?

No. Each manufacturer designs domes to fit its own receivers or tubes, and sizes vary between brands. Use domes made for your hearing aid, in the type and size your audiologist chose.