Systems for manufacturing oral-based hearing aid appliances utilizing various manufacturing methods and apparatus are described herein. The oral appliance may have an electronic and/or transducer assembly for receiving incoming sounds and transmitting processed sounds via a vibrating transducer element coupled to a tooth or teeth. The oral appliance may be formed or fabricated via three-dimensional digital scanning systems or via impression molding to create a housing for the electronics and/or transducer assembly as well as to securely conform the appliance to the user's dentition.