Sir, I read with great interest the letter on ‘Ear protection for dental practitioners' published on 9 February 2024.1 During the pandemic and even post-pandemic, many protective measures have been added to dental offices, contributing only to more noise. We have tried to highlight this issue during the pandemic, where we made an effort to account for noise coming from different instruments commonly used in dental practice.2 While the authors of the current letter only mention that air rotors create high noise levels, we found that many commonly used instruments create even more noise. Typical examples would be scalers that were found to be generating 85.80 dBAeq of sound, while an air-blow syringe was leading to 100.00 dBAeq of noise generation during use.

While the authors have made a great effort to highlight the dementia-associated risks due to prolonged exposure to noise in a dental setting, there are many other associated risks, such as behaviour, digestion, cardiovascular system, and even neurological problems.

As dentists, we must be aware of the initial signs and symptoms of damage caused by noise damage, such as asking patients to repeat sentences, not hearing the phone ringing, or are unable to comprehend voices when there is background noise. The ADA has laid down guidelines regarding hearing loss, including the use of noise-cancellation headphones and ear plugs to prevent hearing damage.3