At Ear Care Dorset, our commitment is simple: to provide safe, evidence-based ear care that reflects recognised national clinical guidance.
The National Institute for Health and Care Excellence (NICE) provides guidance on the assessment and management of hearing loss and earwax in adults, including when earwax removal may be appropriate, which methods can be considered, and when symptoms or findings may require further medical assessment.
These principles form an important part of our approach to ear care.
Below, we explain how our service reflects NICE guidance, particularly around ear health assessment, recognising when referral may be appropriate, and providing safe earwax removal.
1. Ear Health Assessment Comes First
Before considering earwax removal, we carry out an ear health assessment relevant to the treatment we provide.
This helps us understand your symptoms, examine your ears and determine whether earwax removal is appropriate.
Our assessment includes:
Taking a history
We ask about your symptoms and relevant ear health history, including issues such as:
Hearing changes
Ear discomfort or pain
Discharge
Tinnitus
Dizziness or vertigo
A blocked or full sensation
Previous ear problems, procedures or surgery
Understanding your symptoms and medical history helps us assess whether earwax may be contributing to the problem and whether there are any reasons treatment should be postponed or further medical advice sought.
Examining the ears
Using an ear camera and otoscope, we examine the ear canal and tympanic membrane (eardrum) where it can be visualised.
Earwax can sometimes prevent the eardrum or ear canal from being examined adequately. NICE recognises this as one of the situations where earwax removal may be appropriate.
We can also show you what we can see inside your ears and, where appropriate, provide before-and-after images following treatment.
Recognising when referral may be appropriate
Not every ear problem is caused by earwax.
During assessment, we also look for symptoms or findings that may require medical or specialist assessment.
NICE provides referral criteria covering issues such as:
Sudden or rapidly worsening unexplained hearing loss
Persistent or recurrent ear discharge
Persistent ear pain
Certain forms of tinnitus
Recurrent or unexplained vertigo
Abnormalities of the ear canal or eardrum
Symptoms or findings that may indicate an underlying condition requiring further investigation
Where findings fall outside our scope of practice or indicate that further assessment is appropriate, treatment may be deferred and we will advise you to seek advice from your GP or another appropriate healthcare professional.
Our structured assessment and referral process helps us identify when earwax removal is appropriate and when further medical assessment should be recommended.
2. When Earwax Removal May Be Appropriate
NICE recommends offering earwax removal when earwax is contributing to hearing loss or other symptoms, or when it prevents adequate examination or another necessary ear procedure.
Earwax build-up can sometimes cause symptoms including:
Reduced or muffled hearing
A blocked or full sensation
Ear discomfort
Tinnitus
It may also need to be removed when it prevents the ear canal or eardrum from being examined properly.
Our assessment helps determine whether removal is appropriate and whether microsuction is suitable for that individual.
If there is little or no wax present, or removal is not clinically necessary, we will explain what we have found rather than performing unnecessary treatment.
3. Microsuction: One of the Earwax Removal Methods Recognised by NICE
NICE guidance includes microsuction among the methods that can be considered for earwax removal in primary and community ear care services.
NICE also states that the person carrying out the procedure should have appropriate training and expertise, understand the contraindications to the treatment and have the correct equipment available.
Microsuction removes earwax using gentle suction while the practitioner views the ear canal directly.
Unlike irrigation, microsuction does not introduce water into the ear canal.
This can make it a useful option in circumstances where irrigation may not be appropriate, subject to individual assessment.
At Ear Care Dorset, microsuction is our chosen method of earwax removal.
Our practitioners are trained and insured to provide microsuction treatment in clients' homes, and every appointment begins with an assessment before treatment is considered.
4. Looking After Your Ears Safely
NICE advises against inserting small objects into the ear canal to remove wax.
This includes cotton buds and other objects that may push wax further into the canal or cause injury.
Inserting objects into the ear can potentially:
Push wax deeper
Irritate or damage the ear canal
Cause bleeding or infection
Damage or perforate the eardrum
If you think you have a build-up of earwax, it is generally better to seek appropriate advice rather than repeatedly trying to remove it yourself.
Professional earwax removal begins with an examination of the ear so that the practitioner can check whether wax is actually present and assess whether treatment is appropriate.
We reinforce safe ear-care advice during our appointments and provide aftercare guidance following treatment where appropriate.
5. Our Commitment to NICE-Aligned Ear Care
Our approach is designed around the same principles that underpin NICE guidance for safe earwax management:
Assessment before treatment
Earwax removal only when appropriate
Recognition of symptoms or findings that may require referral
Microsuction carried out by appropriately trained practitioners
Awareness of contraindications and individual risk factors
Clear aftercare and ear-health advice
No unnecessary treatment
These principles help us provide ear care that is clinically responsible, transparent and tailored to the individual.
6. Why This Matters for You
Good earwax management is about more than simply removing wax.
A proper assessment helps establish whether wax is actually responsible for your symptoms and whether there are any signs that further medical assessment may be needed.
Following recognised clinical guidance means that:
Your ears are examined before treatment
Earwax is only removed when appropriate
Potential warning signs can be identified
Treatment is selected according to your individual circumstances
You receive clear advice about looking after your ears afterwards
At Ear Care Dorset, our aim is to provide professional, compassionate ear care in the comfort of your own home, while working within our scope of practice and following recognised best-practice guidance.
If something does not look right, or your symptoms suggest that further investigation may be needed, we will tell you and recommend the appropriate next step.
For further information, you can read the full NICE guideline NG98, Hearing loss in adults: assessment and management, on the National Institute for Health and Care Excellence website:
https://www.nice.org.uk/guidance/ng98
Professional Ear Care in the Comfort of Your Home
If you're experiencing blocked ears, reduced hearing or discomfort that you think may be caused by earwax, Ear Care Dorset provides professional ear health assessments and microsuction earwax removal in your own home.
We cover Bournemouth, Christchurch, Poole and surrounding areas, with evening and weekend appointments available.
