{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:52:32Z","timestamp":1792615952373,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Dental Education"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dental education involves continuous exposure to high\u2010frequency noise from clinical instruments, which may cause early outer hair cell damage even before professional practice begins. While noise\u2010induced hearing loss (NIHL) is a recognised occupational hazard among dentists, evidence regarding subclinical outer hair cell changes during undergraduate training remains limited. As this study did not include a non\u2010dental, age\u2010matched control group, the observed differences are reported as an association with year of dental education rather than as proof of a causal effect of educational noise exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This comparative cross\u2010sectional study evaluated 140 dental students: 88 first\u2010year and 52 fifth\u2010year at Biruni University. Pure\u2010tone and high\u2010frequency audiometry, transient\u2010evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) were measured to assess auditory function. Environmental noise levels in preclinical and clinical settings were recorded over an 8\u2010h period using calibrated sound level meters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Average noise exposure was 77.1\u2009dB in preclinical and 81.2\u2009dB in clinical settings. While no significant differences were observed in conventional audiometric frequencies, fifth\u2010year students showed significantly elevated hearing thresholds at 9\u201320\u2009kHz (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). TEOAE and DPOAE signal\u2010to\u2010noise ratios were markedly reduced in fifth\u2010year students, indicating early outer hair cell dysfunction (reduced cochlear amplifier function).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings reveal subtle yet measurable outer hair cell changes associated with advancing dental education. Such early alterations, undetectable by standard audiometry, suggest that dental training environments may pose a latent risk for NIHL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides early evidence of an association between advancing dental education and subclinical outer hair cell dysfunction in dental students, emphasising the need to integrate hearing conservation and noise\u2010awareness education into dental curricula to protect future professionals' auditory health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eje.70284","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T01:31:10Z","timestamp":1787535070000},"page":"1869-1879","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Outer Hair Cell Dysfunction Associated With Educational Noise Exposure in Dental Students: Implications for Hearing Conservation in Dental Education"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7894-3752","authenticated-orcid":false,"given":"Merve","family":"Yelken Kendirci","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Biruni University  Istanbul Turkey"},{"name":"Department of Prosthodontics, Faculty of Dentistry Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2969-4757","authenticated-orcid":false,"given":"Mehtap","family":"Ungor","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Medipol University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2986-7463","authenticated-orcid":false,"given":"Handan","family":"Turan Dizdar","sequence":"additional","affiliation":[{"name":"Department of Audiology, Faculty of Health Science Ondokuz May\u0131s University  Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4404-1547","authenticated-orcid":false,"given":"Ahmet Faruk","family":"Erturk","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9006-5630","authenticated-orcid":false,"given":"Ilknur","family":"Ozcan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2004.00219.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1021\/es305161z"},{"issue":"1280","key":"e_1_2_11_4_1","first-page":"33","article-title":"Epidemiology of Noise\u2010Induced Hearing Loss in New Zealand","volume":"121","author":"Thorne P. R.","year":"2008","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(200001)37:1<112::AID-AJIM9>3.0.CO;2-#"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0579.2006.00393.x"},{"issue":"6","key":"e_1_2_11_7_1","first-page":"1","article-title":"Implementing an Effective Hearing Conservation Program for Dental Students","volume":"3","author":"Sharma M.","year":"2016","journal-title":"Canadian Audiologist"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2012.06.006"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102533"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3913(81)90336-X"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s007840050078"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00130832-200410000-00012"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2845-09.2009"},{"issue":"2","key":"e_1_2_11_14_1","first-page":"150","article-title":"Noise Levels Encountered in Dental Clinical and Laboratory Practice","volume":"11","author":"Setcos J. C.","year":"1998","journal-title":"International Journal of Prosthodontics"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/19338244.2016.1179169"},{"issue":"2","key":"e_1_2_11_16_1","first-page":"110","article-title":"Are Dental Hygienists at Risk for Noise\u2010Induced Hearing Loss? A Literature Review","volume":"55","author":"Henneberry K.","year":"2021","journal-title":"Canadian Journal of Dental Hygiene"},{"issue":"2","key":"e_1_2_11_17_1","first-page":"73","article-title":"Clinical Dental Noise and Its Association With the Hearing Thresholds of New Zealand Dental Students and Clinical Staff","volume":"114","author":"Ma R.","year":"2018","journal-title":"New Zealand Dental Journal"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61613-X"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14091084"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/03005369309076702"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/03005369409077315"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182a28b80"},{"key":"e_1_2_11_23_1","first-page":"82","article-title":"Occupational Health Hazards in the Current Dental Profession\u2014A Review","volume":"81","author":"Gambhir R. S.","year":"2011","journal-title":"Mercury"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-005-0003-6"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1875-595X.2000.tb00544.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1834-7819.1997.tb00105.x"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.15070"},{"issue":"3","key":"e_1_2_11_28_1","first-page":"105","article-title":"Noise Levels in Dental School Clinics","volume":"110","author":"Al\u2010Dujaili M.","year":"2014","journal-title":"New Zealand Dental Journal"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/bdjopen.2016.6"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062347"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2016.1177646"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.7162\/S1809-97772012000200012"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-03392-2"},{"issue":"1","key":"e_1_2_11_34_1","first-page":"S488","article-title":"Hearing Assessment of Dental Personnel: A Cross\u2010Sectional Exploratory Study","volume":"12","author":"Shetty R.","year":"2020","journal-title":"Journal of Pharmacy & Bioallied Sciences"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.4894719"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3109\/14992027.2014.893375"}],"container-title":["European Journal of Dental Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eje.70284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eje.70284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eje.70284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:15:52Z","timestamp":1792613752000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eje.70284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/eje.70284"],"URL":"https:\/\/doi.org\/10.1111\/eje.70284","archive":["Portico"],"relation":{},"ISSN":["1396-5883","1600-0579"],"issn-type":[{"value":"1396-5883","type":"print"},{"value":"1600-0579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]},"assertion":[{"value":"2025-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}