How to Put in Hearing Aids: Insertion, Removal, and Fit Tips by Style

People search for how to put in hearing aids after the fitting appointment when they get home and cannot replicate what the clinician showed them, when insertion becomes difficult after months of easy use, or when a new caregiver or family member needs to help. Insertion is a skill that takes practice, and the technique is different for every style. This page provides step-by-step insertion and removal instructions for RIC, BTE, and in-ear devices, explains how to identify left from right, describes what correct seating feels like, and clarifies when insertion difficulty means you need a fitting adjustment.

General insertion rules that apply to all hearing aid styles

How do you put in hearing aids? The basic process is: clean and dry your hands, identify which device goes in which ear (red for right, blue for left), hold the device by the body or handle (not by thin wires or tubes), gently open your ear canal by pulling your earlobe down and back if needed, insert the earpiece (dome, mold, or shell) with a slight twisting motion, and seat the behind-the-ear portion or faceplate until it feels secure and comfortable. The exact technique depends on whether you have a receiver-in-canal (RIC) device with a dome, a behind-the-ear (BTE) device with a custom mold, or a custom in-the-ear shell.

Regardless of style, follow these universal rules:

• Always insert over a soft surface like a towel, bed, or table with a cloth, so a drop does not crack the shell or damage the electronics. Oticon care guidance recommends holding hearing aids over a soft surface to prevent damage if dropped.
• Wash and dry your hands first. Moisture and oils from your hands can transfer to the device and cause feedback or damage. FDA care guidance warns to avoid water on hearing aids because it can damage internal electronics.
• Insert in good lighting, ideally in front of a mirror until the process becomes automatic.
• Turn the hearing aid on before or after insertion, depending on your clinician's instructions. Some users prefer to insert the device while it is off to avoid feedback during seating, then turn it on once it is in place. Others leave it on. Follow the routine your fitter recommends.
• Do not force. If insertion hurts or feels stuck, stop and troubleshoot. Forcing can damage the device, your ear, or both.

How to identify left from right: the color convention

Hearing aids are programmed and shaped specifically for each ear, so left and right are not interchangeable. The industry-standard marking system uses color coding:

• Red indicates the right ear. Look for a red dot, a red letter R, a red-colored shell or faceplate, or a red stripe on the body of the device.
• Blue indicates the left ear. Look for a blue dot, a blue letter L, a blue-colored shell, or a blue stripe.

This red-right, blue-left convention matches the audiogram symbol standard described in ASHA Guidelines for Audiometric Symbols (adopted by the ASHA Legislative Council November 1989, published 1990), where red O represents the right ear and blue X represents the left ear on hearing test graphs. The color system is nearly universal across manufacturers, but always confirm the marking system for your specific devices during the fitting appointment. Some manufacturers use only letters (R and L) without color, or mark only the right device with red and leave the left unmarked.

If your hearing aids do not have visible color markings, ask your clinician to add a colored sticker or mark them clearly so you or a caregiver can identify left from right quickly.

How to insert RIC (receiver-in-canal) hearing aids with domes

RIC devices are the most commonly fitted style today. The processor sits behind your ear, and the receiver (speaker) sits in your ear canal on a thin wire, with a soft silicone dome holding it in place. For details on dome styles, sizes, and how they affect fit and seal, see our hearing aid domes guide.

Step-by-step insertion for RIC devices

1. Identify left and right. Check the color marking (red for right, blue for left) on the device body behind the ear.
2. Hold the device by the body, not by the thin wire or dome. The wire is delicate and can detach if pulled.
3. Tilt your head slightly toward the opposite shoulder to make the ear canal more accessible. For example, when inserting the right hearing aid, tilt your head slightly to the left.
4. With your opposite hand, gently pull your earlobe down and back to straighten and open the ear canal. This is especially helpful during the first few weeks of practice.
5. Guide the dome into the canal with a gentle push and slight twisting motion. The dome should slide in smoothly. If it catches or hurts, stop and reposition. The receiver wire should angle naturally toward the canal opening.
6. Position the body of the device behind your ear, resting it in the groove between your ear and your head. The wire should curve smoothly over the top of your ear without kinks or sharp bends.
7. Check the position. The dome should feel snug and secure in the canal, the device body should sit comfortably behind your ear, and you should hear clear sound without feedback (whistling).

Removal for RIC devices

1. Grasp the body of the hearing aid behind your ear, not the thin wire.
2. Gently pull the device up and away from your head to lift it off your ear.
3. Remove the dome from your ear canal by pulling gently outward with a slight twisting motion if needed. If the dome feels stuck, try wiggling it gently rather than yanking.
4. Inspect the dome and wire for earwax or damage. Clean the dome daily with a soft dry cloth as described in our cleaning hearing aids guide.

Phonak SDS 4.0 guidance says the dome should fit snugly and comfortably and retain the receiver. ReSound AllFit guidance adds that a good fit is comfortable and slightly resists removal. If the dome slips out too easily or whistles during use, it may be too small. If insertion is painful or the sound is muffled, the dome may be too large.

How to insert BTE (behind-the-ear) hearing aids with custom earmolds

Traditional BTE devices route sound through a tube into a custom-molded earpiece. The mold is made from an impression of your ear and fits snugly into the ear bowl and canal. For details on BTE styles and when custom molds are better than domes, see our types of hearing aids guide.

Step-by-step insertion for BTE with custom mold

1. Identify left and right. Check the color marking on the BTE body or the mold itself.
2. Hold the earmold (not the BTE body or tube) between your thumb and forefinger.
3. Tilt your head slightly toward the opposite shoulder.
4. With your opposite hand, pull your earlobe down and back to open the canal.
5. Guide the canal portion of the mold into your ear canal first, angling it slightly forward and twisting gently as needed. The canal tip should slide in smoothly.
6. Press the body of the mold into the outer ear bowl (the concha) and make sure it sits flush with no gaps. The helix portion (the curved top part of the mold) should lock into the upper fold of your ear.
7. Position the BTE body behind your ear, resting in the crease. The tube should curve naturally over the top of your ear.
8. Check the fit. The mold should feel secure and fill the ear bowl completely. You should hear clear sound without feedback. If the mold rocks or you hear whistling, it may not be seated fully.

Removal for BTE with custom mold

1. Lift the BTE body away from behind your ear.
2. Grasp the bottom of the earmold (the part near your earlobe) and gently pull outward and downward with a slight twisting motion.
3. Do not pull on the tube, because it can detach from the mold or the BTE body.
4. Clean the mold and tube daily. Some molds can be washed with mild soap and water after detaching from the hearing aid body, then dried completely before reconnecting. Check your user guide for whether your mold is washable.

How to insert custom in-the-ear (ITE, ITC, CIC) hearing aids

Custom in-ear devices are molded to fit your ear anatomy and sit entirely in the ear bowl (ITE), in the canal opening (ITC), or completely in the canal (CIC). They have no behind-the-ear component. Smaller models (CIC and IIC) include a thin removal handle or cord. For style trade-offs and when in-ear devices are appropriate, see our types of hearing aids guide.

Step-by-step insertion for ITE, ITC, CIC

1. Identify left and right. Check the color marking on the faceplate or shell (red for right, blue for left).
2. Hold the device by the faceplate or body, not by the removal handle or cord. The handle is for removal only and can break if used for insertion.
3. Tilt your head slightly toward the opposite shoulder.
4. With your opposite hand, pull your earlobe down and back to open and straighten the ear canal.
5. Align the canal portion of the shell with your ear canal and guide it in gently with a slight twisting motion. For CIC and IIC devices, the canal portion inserts first and deepest.
6. Press the faceplate or body of the shell into the ear bowl (for ITE) or canal opening (for ITC and CIC) until it sits flush and secure. You should feel the shell lock into place.
7. Check the fit. The shell should sit comfortably with no gaps, produce clear sound without feedback, and stay in place when you move your jaw.

Removal for ITE, ITC, CIC

1. Grasp the removal handle, cord, or faceplate. For ITE devices, you can usually grip the faceplate. For ITC and CIC devices, use the small handle or cord attached to the shell.
2. Pull gently outward and slightly downward with a twisting motion if needed. Do not yank or force.
3. If the device feels stuck, try wiggling it gently or pulling your earlobe down to release the seal. Do not pull harder, because custom shells are rigid and forcing can hurt your ear.
4. Clean the shell, vent, and wax filter daily. Custom in-ear devices sit in a wax-heavy environment and clog faster than behind-the-ear styles.

Custom shells are matched to your ear anatomy at the time of the impression. If your ear changes shape (due to weight changes, aging, or jaw issues), the shell may no longer fit correctly. Persistent discomfort, feedback, or a loose fit after cleaning and reseating means the shell needs a remake. See your clinician.

How to insert OTC earbud-style hearing aids

Many over-the-counter (OTC) hearing aids use an earbud or in-ear monitor design similar to consumer wireless earbuds. According to the FDA OTC hearing aid rule (effective October 17, 2022), OTC devices are intended for adults 18 years of age and older with perceived mild to moderate hearing loss and allow self-fitting or user customization through controls, tests, or smartphone apps. For candidacy details and OTC vs prescription decision criteria, see our OTC vs prescription hearing aids guide.

General OTC earbud insertion steps

Insertion technique for OTC devices varies by model. Most follow an earbud-like process:

1. Identify left and right. Check the L and R markings or color coding on each earbud.
2. Select the correct eartip size. Most OTC devices include multiple silicone or foam eartip sizes. Start with the medium size and adjust if needed.
3. Hold the earbud by the body, not by the eartip.
4. Pull your earlobe down and back to open the canal.
5. Insert the eartip into the canal with a gentle push and slight twist. The body of the earbud should sit comfortably in the outer ear.
6. Check the fit. The eartip should seal gently in the canal, the device should feel secure, and you should hear clear amplified sound. If the earbud falls out or you hear thin sound, try a larger eartip. If it hurts or feels too full, try a smaller eartip.

Removal for OTC earbud-style devices

1. Grasp the body of the earbud and pull gently outward with a slight twisting motion.
2. Do not pull on charging contacts or microphone openings, because those can damage.
3. Clean the eartips and body daily according to the manufacturer instructions for use.

Because OTC devices allow self-fitting, you are responsible for selecting the correct eartip size and adjusting the amplification through the device controls or app. If insertion is difficult or the fit is poor after trying all supplied eartip sizes, consult the manufacturer or consider seeing an audiologist for a hearing evaluation and professional fitting.

How to tell if your hearing aids are inserted correctly

A correctly inserted hearing aid should meet all of these criteria:

• Feels secure and comfortable. The device should stay in place when you talk, chew, smile, and move your head. It should not hurt, itch, or feel like it is about to fall out.
• Produces clear sound without feedback. You should hear amplified speech and environmental sounds clearly. Whistling or squealing (feedback) during normal use indicates a poor seal or incorrect positioning. For feedback troubleshooting, see our hearing aid feedback guide.
• Matches the position your clinician demonstrated. The dome, mold, or shell should sit at the depth and angle your fitter showed you during the fitting appointment. For RIC and BTE devices, the body should rest behind your ear in the natural crease. For custom in-ear devices, the faceplate should sit flush with the ear bowl or canal opening.
• Allows natural jaw movement. Chewing, talking, and yawning should not cause the device to shift, pop out, or trigger feedback. If jaw movement dislodges the device or causes whistling, the fit may be marginal and need adjustment.
• Does not cause pain or pressure. Mild awareness of the device is normal during the first few days, but sharp pain, throbbing, or pressure that worsens over hours indicates a fit problem. Remove the device and see your clinician.

AAA Guidelines for the Audiologic Management of Adult Hearing Impairment (2006) specify that physical fit verification includes comfortable fit and that patients should be able to insert and remove the device easily. If you cannot achieve a comfortable, secure fit after practicing the insertion technique, the problem is usually the device fit or size, not your technique.

Common insertion mistakes and how to avoid them

When insertion difficulty means you need a clinician

Some insertion problems are technique issues that resolve with practice. Others indicate a fit problem that only your hearing care professional can fix. See your clinician when:

• Insertion is still difficult after a week of daily practice and following the steps your clinician taught you. Persistent difficulty suggests the dome is the wrong size, the mold does not match your anatomy, or the style is too small for your dexterity.
• Insertion causes pain every time, even when you insert gently and slowly. Pain indicates the earpiece is too large, inserted too deep, or the shell shape does not match your current ear anatomy.
• The device falls out repeatedly during normal activities like talking, chewing, or walking. This means the dome is too small, the mold has shrunk, or your ear has changed shape since the impression was taken.
• Feedback (whistling) occurs every time you insert the device, even after cleaning and checking the position. Persistent feedback during insertion indicates a seal problem that cleaning will not fix. For complete feedback troubleshooting, see our hearing aid feedback guide.
• Insertion was easy for months and suddenly becomes difficult. This suggests your ear anatomy has changed, the dome or mold has degraded, or earwax buildup is obstructing the canal. Your clinician can inspect the ear, clean wax safely, and adjust the fit as needed.
• You have arthritis, tremor, low vision, or other dexterity limits and cannot handle the small components. Your clinician can recommend a larger, easier-to-handle style or discuss caregiver training. For style options and dexterity considerations, see our types of hearing aids guide.
• A caregiver or family member needs to insert the devices for you and training is needed. Your clinician can provide hands-on instruction for the caregiver and may adjust the fit to make insertion easier for someone else to perform.

Insertion difficulty is one of the most common reasons for hearing aid abandonment, according to patient surveys cited in audiology literature. Do not tolerate persistent difficulty. A properly fitted hearing aid should be insertable with reasonable practice. If it is not, the fit needs adjustment or the style needs changing.

Where this fits in a purchase (soft product context)

Insertion training is not a separate service you buy. It is part of the hearing aid fitting appointment included in the purchase price at most clinics. When you browse the hearing aid catalog or compare clinic quotes, assume that insertion and removal coaching is included in the fitting appointment. Ask each clinic:

• How much time is allocated for insertion and removal practice during the fitting?
• Can I schedule a follow-up visit specifically for insertion technique if I struggle at home?
• Is caregiver training available if a family member will be inserting the devices for me?
• What is the process for adjusting dome size or remaking a mold if insertion remains difficult?

For the broader decision order (audiogram first, then features, then style, then technology tier), use our how to choose hearing aids guide. For what happens at the fitting appointment and why real-ear verification matters, see our hearing aid fitting guide.

Frequently asked questions