Why aren't custom earmolds the default option?

I got my first pair of RIC (Oticon Opn S1) at the beginning of 2020. Until a week ago I had generic domes. I was happy with them, but had to push them into place a few times a day. This annoyed me enough to request custom molds.
It is less than one week since I got the custom molds (Oticon LiteTip large vent). The performance and comfort is not comparable. The custom molds sit tight in the ear the entire day and I don’t even notice their presence. My subjective impression is that everything is clearer, especially in noisy situations.
I had to pay ~$100 for them, but I feel that saving $100 on a pair of HA that cost a few thousand dollars doesn’t make sense and custom molds should be the default choice.
Any thoughts on why that’s not the case? (given that my experience wasn’t a one-off)

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Although many people love custom molds, your experience is not universal. Many people are happy with domes. That said, I suspect more people could be happier if they tried custom molds. It’s a balancing act. Getting custom molds may or may not help. Fitters likely only encourage it for the ones they’re confident it will help. There is time and expense involved (both patient’s and provider’s)

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In the past I have dealt with domes, and found them a pain in the rear. I have most of my hearing aid life gotten my aids from the VA and at the time I had the domes I was new to aids and domes, and I complained every time I had an appointment about the domes working out of my ear canals. I kept asking for something different and all they would do was try a different dome. That went on until it was time for new aids and I demanded ITE aids, and have had them until my present aids. I now have OPNS rite aids with ear molds that are as close to the ITE aids that I have worn in the past and love them.

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I tried custom molds about a week or so ago, I lasted two days with them before I had to give them up. Made clarity worse for me. They were very comfortable and stayed in place well. Audi told me they may not help me and could even not be as good as domes, she was right. Widex rep said I needed them. I may try them one more time now that I have different HAs just to make sure it was the molds and not the HAs.

Kim -
I have wondered about this myself. My first HA came w. custom fitted molds - I assumed everyone’s did. It was 2 or 3 years later being active on forum that I realized that the term “dome” was an off-the-shelf mold. Didn’t/doesn’t make sense to me why people didn’t get a custom fit. There is even a major diff. in size/shape between my 2 ear canals.

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I am wearing ‘off the shelf’ domes, however- As my hearing worsens it’s evident I will eventually be obliged to switch to custom molds. I am on the cusp of continual feedback with the amplification I now require. I don’t look forward to this as I have found the domes more comfortable than the “years ago” custom in-the-ear aids I started with.

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I have always had BTE aids and custom molds. I had seen people without molds which I also learned here are called domes. I mistakenly thought those must be PSP’s and not true hearing aids. Learned that was not so here too.

I won’t say it is standard practice, but I have not seen the VA fit anything but molds. There wasn’t any discussion when I got my aids from them. They just said they would fit molds. I had tried domes before, and found them fairly comfortable. I thought I wouldn’t like molds, but find them about the same, comfort wise as domes. They do have some undesirable qualities. Some people just flat out don’t like molds, and others find them too uncomfortable. I am glad we have choices.

I understand that many custom mould wearers really like them and do not get that some of us actually prefer domes. Choice in everything!

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The domes kept working out of my ear canals. I use an open dome on left aid and a power dome on right aid due to the hearing loss being more substantial in that ear which caused a ‘stuffed up’ feeling in the right ear. I ordered and wore custom molds (all Costco) until the little lanyard used to pull the mold out of my ear broke off on left mold. Started using wire to remove which caused the speaker to pull out of mold. Mold manufacture would not warranty so I paid for and ordered new molds. They changed the mold to the point that they are difficult to insert in ear. Also they continue to manufacture the wrong size vent into the mold frustrating my Hearing Aid Specialist. Love my molds but the 50 mile trip to Costco each time is getting frustrating. I’ll never go anywhere else for aids/molds.

I have canal lock silicone molds. The canal lock is a piece of the mold that can be grabbed and used to pull the mold out of the ear without damaging tubes or receiver wires.
Pretty handy.

Pretty sure they’re not the default anymore because hearing aid companies wanted to encourage people “of a certain age” to buy more hearing aids and be able to take them home that day, and that’s what domes enable. Theoretically, they’re less visible, and generally folks seem to find them better. (The small subset of folks who come on forums are not at all representative…we’re here either because we’re really angry, or we’re really happy.) But for folks who have more hearing needs, agree, molds should be the default. I was absolutely miserable in power domes. You can get a feel for that looking back at my post history.

John, they fit my new aids with domes, but I could not get them to stay in place, and never at the same depth from day to day. I got custom molds after 2 months battling the darn things. NEVER again. This was my first trip to dome land, and it is the last, have used custom molds for many years with great success…

A question for the pros, which mold material is best to reduce vibrations in the canal?

I assume softer material over hard, which mine were hard. I really likes the custom molds except they seem to make my vibration problem even worse.

Like I said, there are people who love one or the other and hate whichever they don’t love. Having used both, I would take molds. But not by too big of a margin. I tried some what are known as “power” domes once, and didn’t like the occlusion. I actually get some occlusion with vented molds. One of my big complaints about aids in general is the way my own voice sounds. It sounds like I am narrating my life into a cheap microphone. Glad you got some molds you like.

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Of course, there are as many opinions as people who wear hearing aids. But for me it is not even close. I find well fitted molds comfortable, secure and the sound is better than domes. It is up to your audi to do a good impression and to use a reliable lab. I generally use acrylic molds because it is easier to vent them. However, silicone molds are a little more comfortable. I have both and sometimes switch off.

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I too prefer my soft molds with canal locks, but a skillful fitting with the injection device is so important for a perfect fit. My present molds seemed to be perfect when I got them but now I am of the opinion that they need to be a bit snugger, but we are still observing home confinement in our area and age, so I am managing with them until I feel comfortable going back into our local Costco. I did lose some weight during the pandemic but I didn’t think it made my canals wider but anything is possible. :rofl:

After years with domes and

After years with various domes, I opted for custom molds. The first set were made of hard plastic (acrylic?) and I found them no better than the std domes. They still moved and i found myself constantly pushing them in.

Then I saw a post here about silicone molds and talked to my audi and ordered these. What a difference. They are very soft and flexible, and stayed in place all day. I had them remade because they were a little too large and over a few days were painful. The new ones were fine, but I discovered that one came with a higher volume wire and the clarity dropped as there was too much distortion.

An earlier post here that someone said it was worse, might be because of this. I had the wire changed and all worked out.

Probably me. Yeah I’m curious about this because my molds slipped on the receiver, same wire as with domes.