Oral, Eye, and Hearing Health:

Assessment, Treatment, and Equity

Oral, eye, and hearing health is a critical component of overall health. New biological understanding, the development of new technologies, and public health efforts supporting more equitable and comprehensive oral, eye, and hearing health care have improved the lives of billions of people since 1970.

1970

Detecting Hearing Loss in Infants

Detection of the auditory brainstem response (ABR) revolutionized hearing tests in infants when it was introduced in 1970. During the test, surface electrodes placed on the scalp measure the brain response elicited in reaction to auditory stimuli, typically a brief click. By providing a way to determine the functionality of the inner ear and brain, the test enabled doctors to detect hearing problems just hours after birth.

1970s

Advances in Cataract Surgery

The introduction of intraocular lenses in the 1970s and the greater use of phacoemulsification have transformed cataract surgery and improved the quality of lives of patients suffering from visual impairment due to the clouding of the natural lens. Before then, patients required eyeglasses, which did not provide the same clarity of vision that intraocular lenses offered. Further innovations in cataract surgery and the design and use of intraocular lenses have contributed to cataract surgery becoming safer, more effective, and more accessible to greater segments of the population.

1972

The Modern Era of Contact Lenses

Although soft contact lenses were introduced in some countries during the 1960s, significant problems prevented their widespread adoption. In 1972, the first U.S. Food and Drug Administration–approved soft lenses were launched in the United States, by which point many of the early problems with the product had been resolved. Consumers enjoyed the increased comfort of soft contact lenses over hard contact lenses, and later advances further increased their convenience, affordability, and adaptability. Today, more than 90 percent of people worldwide who wear contact lenses use soft lenses.

1984

Restoring Hearing Through Cochlear Implants

Though the first single-channel cochlear implant was introduced in 1972, the technology did not find commercial success until 1984 with the introduction of the first multi-channel cochlear system. The first effective treatment for deafness and severe hearing loss, the device converts sounds into electrical currents that directly stimulate the auditory nerve to produce hearing, bypassing damaged or missing structures within the inner ear. By the end of the 1980s, despite controversy surrounding its effectiveness and application among the deaf community, the cochlear impact had become the predominant treatment for profound deafness in many parts of the world.

1991

Invention of LASIK Eye Surgery

Invented in 1991, Laser-Assisted In Situ Keratomileusis, commonly known as LASIK eye surgery, can correct near-sightedness, farsightedness, and astigmatism. During the procedure, a doctor cuts a thin flap of cornea, providing access to the underlying tissue. The thickness of the corneal stroma is then reduced with a laser to correct myopia, after which the flap is folded back into place, and natural healing processes reseal the cut. LASIK eye surgery received U.S. Food and Drug Administration approval in 1999 and quickly earned widespread popularity due to its high success rate, short procedure duration, and quick recovery time.

1991

A Revolutionary New Diagnostic Tool for Eye Diseases

First demonstrated in 1991, optical coherence tomography uses backscattered or backreflected light to produce high-resolution, cross-sectional imaging of all the major structures inside the eye. By providing rapid, simple, precise, and noninvasive mapping at the microscopic level, particularly the macula and optic nerve, the technique has revolutionized the detection of pathologic changes in these structures, dramatically changing the way patients with age-related macular disease, diabetic retinopathy, and glaucoma are diagnosed and treated. These diseases, considered the causes of blindness, are highlighted in the 2016 National Academies of Sciences, Engineering, and Medicine report Making Eye Health a Population Health Imperative.

1992

The Benefits of Fluoride

To combat the high rates of tooth decay among Americans, particularly among children, the first U.S. cities fluoridated their water sources in 1945. Many other cities and towns followed suit over the next several decades, and by 1992 the majority of Americans were receiving fluoridated water, contributing to a widespread decline in dental carries (tooth decay). Today, tooth loss is no longer considered inevitable, and American adults are increasingly retaining most of their teeth for a lifetime.

1996

The First Digital Hearing Aid

In 1996, Senso, the first digital hearing aid for commercial use, was released. By efficiently filtering out unwanted noise, the device represented a significant advance over previous technologies that amplified both speech and other sounds. The leap from analog to digital technologies spurred a much greater focus on improved signal processing in hearing aid development.

1997

Alternatives to Braces

With the invention of the Invisalign^® system in 1997, people had an alternative to metal braces to straighten their teeth. The approach used by Invisalign^® and, subsequently, similar providers, relies on an incremental series of transparent plastic aligners that gradually move the teeth into alignment. Though the approach was initially viewed with skepticism by the orthodontic community, increased training and advertising propelled the product into the public spotlight.

2000

Defining the Essential Role of Oral Health

The first U.S. Surgeon General’s Report on Oral Health, published in 2000, argued that oral health is essential to the overall health and well-being of all people. However, the report observed, Americans are not achieving an equal degree of oral health. Despite marked advances in safe and effective oral health practices, the report pointed to “a silent epidemic” of oral diseases affecting the most vulnerable Americans, disparities that persist today.

2011

Health Disparities in Dental Care

More than half of the U.S. population does not visit a dentist each year, greatly increasing their risk of oral health problems. To address this problem, the Institute of Medicine and the National Research Council published Improving Access to Oral Health Care for Vulnerable and Underserved Populations in 2011. Documenting decades of insufficient efforts to eliminate significant disparities in oral health care, the report called for greater collaboration among sectors and a renewed universal commitment to tackling these persistent and systemic problems.

2012

Removing the Background Noise from Hearing Aids

People who use hearing aids often complain about the difficulty in distinguishing voices from background noise, a phenomenon called “the cocktail party problem.” In 2012, researchers developed a machine-learning computer program that can isolate speech from background sounds and separately adjust the volumes of each. Though the program requires more computing power than current hearing aids possess, researchers are working to integrate smartphone and hearing aid technologies to create next-generation devices that can handle all types of noise.