Difference between domes and custom molds

I curious about the differences between domes tulip/power and custom molds (vented?).

If someone to either explain their applications or post a link to information It would be much appreciated.

I’m currently trialing KS6 hearing aids and my old hearing aids were Epoq’s both sets of aids have been with power domes.

Custom domes are standard in the canal fittings that suspend the receiver in your ear canal. They can be open, semi-open (tulip) or fully closed (power) domes. Given your audiogram, open or semi-open is likely sufficient for you. The more closed your dome is, the more the hearing aid is supplying your hearing. Semi-open/open allows you to use whatever natural hearing you have left (bass frequencies are near normal in your case).

Custom molds are what they sound like. They are harder plastic or silicon molds that are created by taking impression of your ear canal and making molds based on that impression. They are designed to fit your ear canal only and to fit perfectly.

If the standard domes perform well for you and stay in your ear, it is perfectly fine to use them. For many, domes are not a good solution and custom molds are necessary. I needed molds.

Good luck


I had to use custom molds as well as the domes kept sliding out of my ear (all size domes). Custom molds give a completely different sound but you get used to it after a while like with domes.

I went with custom molds for retention and comfort issues and would never go back to domes again. Most of the time custom molds are used for people with severe losses in the low frequencies (which you don’t have) to keep the lows from “leaking” out of the ear canal so they can be heard and the wearer has no vent or a small vent to keep occlusion to a minimum. Those who want molds for retention or comfort and have better hearing in the low frequencies have them made with a larger or “open fit” vent which is a large hole in the mold that allows the lows as well as the high frequencies to escape from the ear canal.

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If you can get domes then get them as you will improve your ability to hear.

Again more Widex BS from DD…

So, I am trying to decide if custom mold are worth it for me. I have losses in the low, slowly coming up to the mid, and peaking in the high, then coming back down at the right in the highs. Essentially, I have mild to moderate hearing loss. I have been told at Costco my option for getting rid of feedback is to go to the custom molds. I want to find out from someone that has them how they sound. I am currently in open domes, and I have tried closed domes. I did not like the closed domes, as I felt they amplified low sounds way too much. The car ride with them was awful! So, are custom molds the same? Do they make your own voice sound weird, too? And do you get feedback with them? That is one of my biggest problems right now.

Thank you for any help!

If I do the link correctly, in this post Doubledown gave a really nice picture of domes to explain the different ones.

I started with closed domes, then went to custom molds due to my domes backing out. In my opinion, hearing aids make your voice sound funny, regardless of what’s stuck in your ear. It’s the one thing I have had the hardest time getting used to.

I have Rexton Trax 42s with custom molds, and yes, they amplify low sounds. Mind have the smallest vent, so maybe the largest vent changes that. When I first got the molds, my own voice resonated more and I certainly am more aware of my own chewing of things like potato chips, but I’ve gotten used to it. Brushing my teeth with the aids in was interesting, but I thought it was funny. In my experience road and wind noise when driving was really bothersome when I first got my aids, and I had to use the noise reduction program to stand it. By the time I got the molds I was over that and not bothering to switch out of the automatic program when driving, and for me the molds didn’t change that. I never got feedback with domes (double domes on the Widex I trialed for 2 weeks and tulip domes on the KS6 I trialed for 90 days and on the Trax for the first 60 days or so). I’ve never gotten feedback with the custom molds either.

One big plus for me and a driving factor in getting the molds was with domes the receiver kept slipping out too far, particularly for my right ear. I was pushing on the wire to reposition every couple of minutes. I can’t say that never happens with the molds, but it’s infrequent and no longer a constant annoyance.

“how” hearing aids sound with or without domes is completely subjective, so nobody here will be able to predict how the change from domes to molds will affect your personal perception. And whether or not you LIKE that change is not necessarily relevant to how effective it is and vice versa. You could potentially get the molds, adjust the devices to get optimized and maximum speech clarity with absolutely no feedback, but HATE how they feel and sound. Or you could get molds to feel completely natural and comfortable and wonderful, but only see a 5% improvement in your ability to understand speech.

Domes are just a one size fits all way of approximating what a mold is doing customized for you.

looks like you are trying the brio.

For not having their audio-gram you sure THINK you know what’s best for them. Do you type that bs over and over or do you have a master you cut and paste from?

Robert, you could have the fitter set up a program just for riding in the car if you decide to go with closed domes or custom domes. That’s pretty easily done.

It will help us if you post your audiogram results. Is your current aid behind the ear with the receiver in the canal?

I need to make another appointment at Costco, so right now all I have is a bad print out of my audio-gram. I have 2 RIC Phonak Brio R 312’s. My Costco rep gave me a few different domes to try to see if I liked any of them. I have been desperate to get a solution, so yesterday, I tried the smallest sized closed dome. I didn’t want to scream, so it was an improvement from when I tried before. Maybe I am getting more used to hearing aids in general, but they kept slipping out. Today, I tried the mid-sized closed dome, and I noticed that I had far fewer incidences of feedback. However, I get massive feedback from music and water. It can also happen in louder situations, which is what teaching jr. high is. Loud. Anyway, I did notice less feedback today than before at school. I know I have to go in to have her reset everything for the closed domes, but I’m thinking maybe I should try the large closed domes tomorrow and see if I can handle it.

I think my problem is I have to have the high’s up louder, since I have loss in that range. It seems to set things into feedback. I am only at 90% volume right now, and I have to turn it down one otherwise I get feedback from everything. My mom laughing set it off.

I also still have problems with understanding my students. I saw on another thread that someone said that is “speech in speech noise.” I think when we have previously been adjusting things we just changed speech in noise. Does anyone know anything about this?

robertan99, you have a pretty big difference between your air conduction and bone conduction in both ears. (The hearing by air conduction is marked by Os and Xs; bone conduction is marked by the brackets < and >.) Have you talked with an otolaryngologist about this?

In the bone conduction test they put the sound source right against your skull. That shows how well your cochlea and auditory nerve are working, and your bone conduction scores are pretty good. In the air conduction test the sound has to travel through your ear canal to vibrate your eardrum, which then vibrates a series of three tiny bones in your middle ear. The last of the bones contacts the cochlea, where sensory cells take over. If something is wrong with the ear drum or if something in the middle ear is stopping the bone vibrations, the air conduction scores will be worse than the bone conduction scores. It’s called a conductive loss, and sometimes that type of loss can be corrected by short-term medication or surgery.

I think you need to get those air bone gaps figured out at an ENT office. Based on your air conduction scores, occlusion and overamplifying the lows should not a problem. Since you ARE experiencing difficulties with those things that tends to make me believe your bone conduction scores are a better measure.

So go have an ENT check you out. If that doesn’t yield any answers, then get your audiogram retested just to verify. If your audiogram is legit, then my suggestion would be to manually change your audiogram. Move your air conduction scores to within 5 dB of your bone conduction scores, then recalculate your hearing devices. Air bone gaps are like throwing a wrench into the cogs of most programming software.

Thank you, daisymae and JustinHIS, I really appreciate your help! I have never been told anything about the difference between the bone conductance and the air. I was just told that hearing aids would help me. I have called and set up an appointment with my ENT and with my Costco rep. I am going to take this info in with me. For some reason, I wasn’t able to set up my own account, so I have been using my dad’s account. He also has hearing aids. I don’t know anything about them. I have had hearing loss since Jr. High, and now I’m a teacher at a Jr. High. I’m just now finally doing something about my hearing loss, thanks to my parents. It’s been a rough road so far, but I am really grateful for everyone’s suggestions and help on here!

And BlueCrab, I have had the issue of the domes backing out as well. Do your custom molds not pop out as much?

robertan99, I’m glad you’ll see an ENT. Please let us know how it goes!

I can tell you from personal experience that for what you’ll pay for custom molds they are well worth the additional small cost. I tried small, medium and large domes and none worked. Custom domes work great for me.

My custom molds don’t budge. If you go that route, I recommend concha locks.

Just last week, I broke one of my molds. The HIS ordered a new one. I stopped in the office and the lady at the desk placed a closed dome on there for the time being. Man, I forgot how much of a pain that actually was. I liked the size and simplicity of the domes, but they just don’t stay in place.