This device is just being introduced to the UK. It is not yet available on the NHS.

It is a bone conduction device which does not require an operation.

ITM = In The Mouth

BTE = Behind The Ear

This device is just being introduced to the UK. It is not yet available on the NHS .

It is a bone conduction device which does not require an operation.

It does not matter where the vibrating hearing aid touches the skull(see BONE CONDUCTION DEVICES above) – the vibrations will find their way to a normally working inner ear – where the vibrations will be converted into nerve impulses and take the sound up to the brain where you will ‘hear’ it.

The SOUNDBITE is a device consisting of 2 parts:

1. An In The Mouth(ITM) part – where the vibrating bit is attached to a removable brace which clips on to the back upper teeth.

The upper teeth are strongly secured to the skull – so if you vibrate the teeth the vibrations will spread throughout the skull and find the working inner ear.

soundbite ITM

soundbite ITM 2

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The ITM ( = the In The Mouth) part of the device
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The ITM attaches to the back two upper molar teeth. These teeth have to be in good condition

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2. A Behind The Ear(BTE) part – like a tiny hearing aid which picks up the sound and then transmits it to the In The Mouth part which then vibrates at the appropriate frequencies to reproduce the sound signal.

soundbite BTE 1

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The Behind The Ear (BTE) hearing aid part is very small and discreet.

The microphone of the device sits in the opening of the ear hole and so takes advantage of the pinna which helps funnel sound into the ear canal.

Both the BTE and the ITM need to be charged up each night.

Will I hear myself eating?

No. There is no microphone on the ITM part. It will not pick up sound from inside your mouth.

The sound is picked up by the microphone in the BTE hearing aid part and the information sent wirelessly to the ITM part. So you will only hear what the hearing aid part picks up.

Who Might Benefit From A SOUNDBITE?

Three groups of people may benefit from a Soundbite:

1. Patients with a ONE SIDED severe to profound nerve hearing loss (= a sensori-neural hearing loss)

2. Patients with a CONDUCTIVE hearing loss

3. Some patients with a MIXED hearing loss


People who have only one hearing ear often have a lot of problems:
hearing people on their deaf side
hearing in background noise
localising where sounds come from

A normal hearing aid doesn’t work because the inner ear on that side is not working. However if the other ear has normal nerve hearing then the output from a bone conduction device will reach that normal nerve allowing the patient to hear.

Causes of a single sided deafness:

  • Trauma
  • Viral infection
  • Labyrinthitis
  • Severe Menieres disease
  • Sudden sensori-neural hearing loss
  • Acoustic neuroma removal
  • Congenital (i.e. born with only one hearing ear)

The Soundbite is usually attached to the teeth on the hearing side and the behind the ear hearing aid part will be paced on the deaf side. However if the teeth on the good hearing side are not suitable it can be out on the other side. When someone speaks on the patients deaf side the sound is transmitted through to the ITM and the vibrations it creates are transmitted through the bone to the good cochlear on the other side and the patient can hear that person speaking.

How does the soundbite work 1
This image shows the Behind The Ear(BTE) hearing aid on the patients deaf side. The In The Mouth (ITM) vibrating device attached to the upper teeth on the patients hearing side. The cochlea of the hearing ear
soundbite how it works 2
The BTE microphone picks up sound on the patients deaf side and send the information by radio waves to the ITM
Soundbite how it works 3
The ITM vibrates the upper teeth which vibrates the upper jaw. The upper jaw is part of the skull so the skull vibrates. The cochlea is part of the skull bone so the cochlea vibrates. This makes the fluid inside the cochlea vibrate. These vibrations are so tiny that you do not feel them.
Soundbite how it works 4
The nerve endings inside the cochlea detect the vibrations in the cochlea fluid and convert them into nerve impulses which are carried up the hearing nerve to the brain and the patent can ‘hear’ the sound.


This is where sound can not get through to the inner ear. Possible causes are listed below. Often this sort of hearing loss can be treated with a normal hearing aid but some people can not use a normal hearing aid either because it causes ear infections or because the patient may not have an ear or ear canal.

For people with a conductive hearing loss and repeated infections whenever they use a normal hearing aid, using a Soundbite can be effective at not only helping the hearing but also allowing the ear to dry up and avoid infections because the ear canal is no longer blocked.

Causes of a conductive hearing loss where Soundbite may help:

  • abnormal or absent pinna
  • blocked or absent ear canal
  • maybe in people with: recurring ear canal infections, chronically infected hole in the ear drum or any cause of a conductive hearing loss where a normal hearing aid causes problems. This will depend whether or not the much more loosely fitting microphone irritates the ear canal.

In a conductive hearing loss the Soundbite works in the same way as described above in the pictures; except the ITM would be worn on the same side as the BTE and the sound vibrations would find their way to the good cochlea bypassing any problems in the ear canal or middle ear.

3. MIXED hearing loss

In some people with a conductive hearing loss the inner ear is also not working very well. For these people a certain degree of amplification is needed.

The SOUNDBITE claims to provide enough amplification as long as the nerve hearing loss is not greater than 40dB.

For the time being I am only fitting people with a pure conductive hearing loss – in other words people who have a conductive problem but with normal nerve hearing. I want to wait and see some more long term results for patients with an added nerve hearing loss.

The Process

The treatment pathway consists of four parts:

1. Assessment by an ENT surgeon with hearing assessment

2. Assessment by a dentist

3. Fitting by the dentist

4. Programming of the device by an Audiologist.

1. Assessment by an ENT surgeon with hearing assessment

Assessment by an ENT surgeon is very important. The surgeon needs to assess the cause of the deafness, the degree of deafness and the type of deafness. Some serious conditions could be causing the conductive or nerve deafness and these need to be excluded or treated. Some causes of conductive hearing loss may be fairly easily remedied. All the other options to help hearing can be discussed. If the person is thought suitable for a Soundbite and wishes to proceed then the next step is a dental assessment.

2. Assessment by a dentist 

The dentist will assess the teeth to look for any gum disease or dental decay and also to ensure that there is enough room around the teeth to accommodate the frame of the device. The dentist will then take an impression of the teeth. The impression is sent to the Sonitus – the Soundbite device company – who manufacture the ITM part so it will fit that patients teeth.

3. Fitting by the dentist

When the ITM is ready the dentist will fit it and ensure that it fits snugly and comfortably.

4. Programming of the device by an Audiologist.

Once the device is fitting well and the patient is happy the Audiologist will dispense the hearing aid BTE part and programme the aid and ensure that it is transmitting data to the ITM correctly.

We will then follow you up on regular intervals in the early stages to make sure everything is okay and working well.


There are very few risks.


The Soundbite is made by Sonitus Medical and their website can be found at:


More information about the Soundbite can be found at:


Patient Comments

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    CW, Dec 2016

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    Mrs CM, Jan 2107

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