Spirit Dental Resources

One trip to the dentist will make you realize that even preventive care like checkups and cleanings can be expensive. And if you’re paying for it all out-of-pocket, you might find yourself avoiding the dentist when you should actually be seeing them regularly. How can you save money on dental bills? The answer is simple: enroll in a dental plan from a top-quality insurance provider like Spirit Dental. But is dental insurance worth it? You bet! Keep reading to discover the value of our dental insurance plans.  9 reasons to choose Spirit Dental 1. 30-day guaranteeWe understand that sometimes things don’t work out. That’s why all of our Individual Dental and Vision plans come with a 30-day Customer Satisfaction Guarantee. After your plan becomes effective, you’ll have 30 days to see how you like it. Not satisfied? No worries, you can just cancel the plan for any reason. We’ll refund the premium you paid, as long as no services were provided. If any services were rendered, you may cancel the policy but you won’t be reimbursed for the premium.   2. History and expertise of Ameritas Life Insurance Corp.Our insurance is offered by Ameritas Life Insurance Corp., which is a company known for high-quality insurance plans and stellar customer service. Today, the Ameritas Dental Network is one of the biggest in the country, with network providers who charge up to 50% less than their usual rates so you can enjoy lower costs. 3. Choose your own dentistAt Spirit Dental, you get to choose between plans that have networks and those that don’t.  Want to avoid networks, or prefer to select your own dentist? No problem! Check out our Choice plans. Don’t mind a network and want to save even more? Our Network plans might be the perfect fit.  4. No waiting periodsSome insurers have dental plans that impose a waiting period before coverage kicks in. It might apply to certain types of care or all types of care. And some waiting periods might be longer than a year. Yikes! This can be really annoying, especially if you need to receive treatment right away.You can avoid this problem by opting for dental insurance plans with no waiting period, like Spirit Dental.. Because we offer plans without a waiting period, once your policy is active, you can make your appointment to see the dentist.5. Guaranteed acceptanceWhen you need insurance, you don’t want to delay getting valuable coverage. And being rejected after taking the time to fill out an application can be frustrating and disappointing. But with Spirit Dental, you don’t need to worry about that.  We guarantee acceptance of your application. Plus, if you need assistance along the way to be sure you submit everything correctly, we’ll gladly help. 6. Implants and major services coveredMajor services may cost hundreds or thousands of dollars, but having the right coverage can reduce your out-of-pocket expenses. Whether your dentist has recommended a crown, bridge, inlay, implant or dentures, our plans can help you afford the care you need. While other insurers might impose waiting periods and restrictions or only offer limited support for major services, our plans provide this coverage from the first month. This means you won’t need to delay receiving treatment, and you won’t need to break the bank either. 7. Three cleanings per yearBrushing and flossing isn’t enough when it comes to keeping your teeth and gums clean and strong. Nothing compares to a professional cleaning, which your dentist might recommend you get more than once a year. To help you maintain a bright and healthy smile, our plans cover three cleanings annually. Compare this to other providers, who might only cover just one or two cleanings each year.  8. $5,000 annual maximumA dental plan with a low annual maximum can make it challenging to get the financial support you need, especially if you have to undergo expensive treatments. Once you reach this limit, you’ll need to pay for care totally out-of-pocket or hold off on getting treatment until a new year starts. Many providers will have annual maximums that are $1,000 to $1,500. But we’re proud to provide higher dental insurance annual maximums, with some plans offering up to a $5,000 maximum per year. 9. Add vision coverage for as little as $7 per monthIf you want vision insurance, we can help. With super affordable premiums as low as $7 per month, our add-on vision plan is designed to help you save money on eye exams, glasses, and contacts. Whether you have a Choice or Network dental plan, getting vision coverage is a snap, so you can have a bright smile and clear vision.    How much is Spirit Dental insurance per month?Unlike other types of insurance that might scare you away when you see how much they cost, dental insurance may be surprisingly inexpensive. Spirit Dental can provide you with the low-cost solution you’re searching for. Plans range from just $36 to $70 per month, and there’s a $100 one-time deductible. Can you get dental insurance anytime? Yes! You don’t have to wait for Open Enrollment to sign up, so you can do it at any time of the year, whether you’re in between jobs, self-employed, or retired and looking for quality coverage.  Ready to get started?Once you know what to look for in dental insurance policies, it’ll become easier to narrow your options to those that are ideal for your needs and budget. Spirit Dental offers a variety of affordable dental plans, and each one comes with a host of perks.Want to see what’s possible? You can get a quote quickly and easily online. And if you need help, we’re here to answer all of your questions.  Sources:https://www.anthem.com/individual-and-family/insurance-basics/dental-vision-insurance/is-dental-insurance-worth-ithttps://www.deltadental.com/us/en/protect-my-smile/dental-benefits/dental-insurance/the-value-of-dental-insurance.html https://www.deltadental.com/us/en/about-us/why-delta-dental.html

Updated March 2023When shopping for a dental plan, it’s wise to read the fine print carefully so you’ll know exactly what you’re buying. When you do that, you might notice that many options come with a waiting period. What is a waiting period for dental insurance? Keep reading to learn about this restriction and how you can avoid it.  What is a waiting period for dental insurance?Put simply, a waiting period is the length of time that you’ll need to wait before your dental insurance policy fully kicks in. During this time, your dental insurance may not cover some procedures.Waiting period lengths will vary by insurer, policy and type of insurance. The waiting period can be as little as a few months, up to a whole year.This waiting period requirement can stand in the way of you receiving necessary professional care sooner rather than later. Imagine having a dental emergency and being unable to use the insurance you purchased—now that’s scary! Why is there a waiting period for dental insurance?Insurance providers that impose waiting periods are trying to protect themselves and keep costs down for consumers. This tactic helps prevent people from signing up for a plan, receiving care, and then dropping the plan. In other words, it’s a way for insurers to dissuade people from signing up for coverage only when they know they have an oral health concern that needs to be treated.  What does a no waiting period mean in dental insurance?No waiting period means your dental coverage is active as soon as your application is approved. No waiting weeks or months before you can take care of that emergency dental procedure for you or your family.Don't worry, you can find dental insurance with no waiting periodsThankfully, there is dental insurance with no waiting period restrictions. It’s just a matter of finding the right plans available in your area. So, as you browse policies that give you the coverage you need, check the details regarding waiting periods.You can indeed find dental insurance with no waiting period for major services. But also consider other factors, such as the cost of the plan and whether or not you need to use a dentist who’s in-network to receive the benefits you want.  Dental insurance waiting period FAQsWaiting periods can be frustrating, so many consumers choose insurers that won’t impose limits on the care they can receive after signing up. If you’re interested in learning more about dental insurance without waiting periods, check out the FAQs below. Can I Use Dental Insurance Right Away?Depending on a plan’s details, you might be able to get coverage for all categories of care (preventive, basic, and major) immediately. But if you also need other types of coverage, keep that in mind.For example, if your child needs orthodontics, it’s a great idea to search for companies that provide dental insurance for braces with no waiting period.As another example, if you’re a senior looking for dental insurance with no waiting period for dentures or implants, you can narrow your options down based on this requirement. How long does dental insurance take to kick in?If you don’t go with a plan that provides comprehensive coverage without any waiting periods, you’ll be limited in terms of the types of treatments you’ll be able to receive at first. But not all plans with waiting periods are identical.Waiting periods might be different for the various categories of care that are covered by an insurer. For instance, you might not need to wait to receive preventive care, but you might need to wait months for basic services coverage or even up to a year or more for coverage of major services. Yikes!For this reason, it’s wise to consider your needs as you shop for insurance. For example, if you need dental insurance with no waiting period for a root canal, you can search specifically for plans that give you that coverage.Can I get dental insurance with pre-existing conditions?It is possible to find dental insurance plans that will cover pre-existing conditions. As is the case with waiting periods, it’s important to read the fine print so you’ll know what is and isn’t covered.Some plans might not cover pre-existing conditions at all. Others might not have any restrictions. And some insurers might limit the types of pre-existing conditions that will be covered. For instance, missing teeth or severe pre-existing conditions might not be covered at all, or you might just need to fulfill a waiting period before coverage kicks in. Can I get dental insurance right before surgery?Yes, you might be able to find a plan that won’t impose restrictions on the types of procedures you can undergo after enrollment. For example, you might be able to get dental insurance with no waiting period for wisdom teeth removal.Basically, if there aren’t any pre-existing condition exclusions or waiting periods on major services, you might be able to enroll in insurance and get support for surgery right away.Can you get dental insurance at any time?Yes, you can sign up for dental insurance at any time. You don't need to wait for an open enrollment period or a new year to start.Spirit Dental has the dental insurance with no waiting period you needDo you want to go with an insurance company that won’t impose annoying waiting periods? Spirit Dental offers a variety of plans to suit the needs of individuals, families, and seniors. And the best part is there aren’t any waiting periods for preventive, basic, or major services! Signing up is simple, and you can contact us anytime with questions about our plans.Let Spirit Dental help you discover a no-waiting-period dental plan that can fit your dental needs. Get started with a free instant quote today.

If you’ve ever had a canker sore, you know how annoying and painful they can be. But what exactly are they, what causes them, and are there any ways to prevent them? Keep reading to learn all about this common oral health ailment. What Are Canker Sores?Canker sores are ulcers or lesions that are described as shallow, small, and oval or round. In terms of their color, they’ll typically be white, yellow, or gray, and there’s also some redness surrounding the sore. These sores develop in the mouth, such as on the inside of the lips or cheeks, at the base of the gums, on the soft palate, and on the tongue. The good news is these sores aren’t contagious, and they generally heal on their own. But while you have them, they can be painful to the point that you have trouble talking or chewing. Note: Minor canker sores are often small and may heal in a week or two, while major canker sores are bigger and may take several weeks to heal.  What Causes a Canker Sore?Experts aren’t really sure what causes canker sores, but certain things might trigger their development. Here are some examples:StressHormonal changesMouth injury (this might be caused by brushing too hard or by accidentally biting the inside of your cheek, as a couple examples)Acidic or spicy foods, or any foods that you’re sensitive toA lack of adequate zinc, iron, folate, or vitamin B12Irritation caused by sodium lauryl sulfate, an ingredient commonly found in toothpaste and mouthwashIrritation caused by braces, dentures, or other dental appliancesOther interesting things to keep in mind about canker sores:If people in your family get canker sores often, you might too. Certain conditions, such as IBD and celiac disease, might cause canker sores. These sores aren’t caused by the herpes virus. How Can You Treat a Canker Sore?Though they can cause quite a bit of discomfort, you don’t necessarily need to do anything to treat a canker sore, as it usually goes away on its own. However, if you want to get some relief, you can try over-the-counter products like Orajel. You can also consult your doctor or dentist to discuss options like prescription mouthwashes if you have a large canker sore that’s causing a lot of pain.    In addition to avoiding triggers like acidic foods and beverages that could make the discomfort worse, you can also try rinsing your mouth with a mixture of water and baking soda or water and hydrogen peroxide. And it’s also wise to brush your teeth as gently as possible to avoid further irritation.   Note: If your symptoms are severe, your sore is really big or isn’t healing, you have a lot of sores that keep coming back, or you have other symptoms (e.g. fever), it’s best to talk to your doctor to figure out how to tackle the problem. Can You Prevent Canker Sores?Here are some simple steps you can take to help prevent the occurrence of unpleasant canker sores:To avoid irritating your mouth, use a soft-bristled toothbrush to thoroughly and gently clean your teeth. And don’t forget to brush and floss daily!Because chewing on gum might cause irritation, avoiding it may be helpful when it comes to preventing canker sores.Test things out to see if you can figure out your triggers. Do you tend to get canker sores after eating a lot of spicy food? Or, you might try switching to products that don’t contain sodium lauryl sulfate (SLS) to see if that’s the irritant you need to avoid.Eat a balanced diet, and take supplements if necessary, to ensure you aren’t deficient in any key nutrients. And practice stress-relieving techniques to keep your mind in a balanced and positive state as well. Can a Dentist Help If You Have Canker Sores?Yes! Your dentist might be able to give you valuable tips about what to do to treat and prevent canker sores. Also, if your canker sores are caused by a dental appliance that needs to be adjusted, or by one or more teeth that have sharp surfaces, your dentist can fix those problems for you. Just more great reasons to have a high-quality dental plan in place!So, to summarize: you generally don’t need to be too worried about canker sores, but don’t hesitate to see your dentist if they’re causing a lot of pain or aren’t healing properly. Sources:https://my.clevelandclinic.org/health/diseases/10945-canker-soreshttps://www.colgate.com/en-us/oral-health/mouth-sores-and-infections/how-to-prevent-canker-soreshttps://www.mayoclinic.org/diseases-conditions/canker-sore/symptoms-causes/syc-20370615https://www.healthline.com/health/dental-and-oral-health/how-to-get-rid-of-canker-sores#alum-powder

Having a cold sore can be really embarrassing. Unfortunately, there’s no cure, so if you have contracted the virus that causes these sores, they’ll continue to come and go. The good news, however, is that there are remedies you can use in order to shorten healing time and relieve discomfort.  Natural Remedies That Are Worth Trying  When it comes to natural remedies for cold sores, consider trying the following to see if they help soothe your symptoms. Gently applying a cold compress to the sore might be helpful if you’re experiencing swelling and pain. By numbing the area, you may be able to get temporary relief.   Getting enough lysine through diet and supplementation might hinder the herpes simplex virus that causes cold sores. You can also find creams that contain lysine if you want to apply it to a cold sore to see if that helps with healing.   Taking vitamin C and vitamin E supplements may be beneficial. Vitamin E might help an existing sore heal, while vitamin C may work on inactivating the herpes virus.   Various ointments, creams, and balms might also be worth a try. Here are several examples: Aloe vera gel, which boasts anti-inflammatory properties, might help you fight the virus, and it may provide soothing relief while supporting healing.   A cream that contains sage and rhubarb might help heal your cold sore faster.   An ointment that contains propolis, which is synthetic beeswax, might help shorten the time that you have a cold sore.   Kanuka honey may be as effective as medication, and you can easily apply it topically.   Diluted tea tree oil or peppermint oil are options that might help heal your cold sore in a shorter amount of time. Tea tree oil boasts antiviral and antiseptic properties, while peppermint oil might help get in the way of the herpes virus.   Lemon balm extract may be beneficial if you want to ensure efficient healing of your cold sore. It boasts antiviral properties, and it might help with reducing inflammation.   Over-the-Counter and Prescription Remedies   In addition to natural solutions, there are also products that you can buy over the counter or get with a prescription from your doctor. Below are a few options to consider: A well-known remedy is Abreva, which can be purchased without a prescription. It’s easy to apply, and it contains ingredients that may help shorten the amount of time it takes to get rid of the sore, especially if you use it as soon as you notice symptoms.   Creams that contain pain-relieving ingredients, such as benzocaine and lidocaine, may make having a cold sore more tolerable. Or, you might try taking pain-relieving pills, such as acetaminophen or ibuprofen, instead.   Your doctor might prescribe antiviral medications that help your body fight the herpes virus. These may also help decrease the amount of time it takes to heal. Examples include Denavir, Zovirax, Famvir, and Valtrex.   A Laser Treatment Offered by Dentists   Some dentists offer a laser treatment that might help stop a cold sore before it appears, provided that you get the treatment in time, such as when you start to feel the tingling that often precedes an outbreak. But what if you already have a sore? A laser treatment might still be an option when it comes to drying it up and disinfecting it, reducing inflammation and pain, and speeding up healing.  To see if this type of treatment would be right for you, just consult with a dentist that offers it.   Can You See the Dentist for an Appointment When You Have a Cold Sore? If you have a cold sore, is it safe to see the dentist, or should you reschedule your appointment? Well, this will depend on your dentist, as well as the type of dental treatment you need.  Simply call your dentist’s office to ask them how to proceed. Your dentist might not want to risk it if your cold sore is contagious, and might advise that you hold off on treatment if it’s possible to do so.  Also, keep in mind that undergoing dental treatments when you have a cold sore might cause it to become irritated or painful, and it might crack or bleed as well. You don’t want that to happen, especially if your goal is to reduce healing time! Be Patient When You Have a Cold Sore It might take longer than a week for a cold sore to go away, so do your best to be as patient as possible. And it may take some trial and error to figure out which of the solutions above will work for you. However, it’ll be worth the effort if it means your cold sore will heal more quickly! Sources: https://www.webmd.com/skin-problems-and-treatments/cold-sores-at-home-care#1 https://www.mayoclinic.org/diseases-conditions/cold-sore/diagnosis-treatment/drc-20371023 https://www.abreva.com/managing-lip-health/dealing-with-cold-sores/truth-about-cold-sore-remedies/ https://www.abreva.com/managing-lip-health/cold-sore-triggers/dentist-visit/ https://www.aad.org/public/diseases/a-z/cold-sores-treatment https://www.dentistry.com/topics/cold-sores/ https://www.dentalhealth.org/cold-sores https://www.aetnadentaloffers.com/dental-health/going-to-the-dentist-with-a-cold-sore https://www.biolase.com/blog/relief-cold-sore-sufferers/ https://www.daydentalcare.com/treatments/laser-cold-sore-treatment/ https://www.health.harvard.edu/diseases-and-conditions/by_the_way_doctor_does_lysine_prevent_cold_sores https://www.webmd.com/skin-problems-and-treatments/qa/can-aloe-vera-gel-treat-cold-sores https://www.uhs.wisc.edu/medical/cold-sores/  

Some people wear mouthguards when they’re playing sports or doing other activities that may put them at risk of mouth injuries. Others need mouthguards that are made for nighttime wear while they sleep so they can combat bruxism or temporomandibular joint disorder (TMD).  Regardless of the reason why you need to wear a mouthguard, one thing that you always want to do is clean it properly. Doing so will help ensure you can keep the mouthguard free of pathogens like bacteria or fungus.    What are some of the easy ways to clean mouthguards? We’ve got you covered with some handy tips below! Be Prepared to Regularly Clean, and Eventually Replace, Your Mouthguard To keep your mouthguard sanitary, it’s best to develop a routine for cleaning it after use. But, after a certain point, it will be necessary to replace your mouthguard with a new one, even if you never skip cleaning it.  When should you replace a mouthguard? Generally, if it becomes damaged in any way, or it starts to irritate your delicate gums, it’s wise to replace it. This will ensure the mouthguard will function correctly and protect your pearly whites comfortably.  Even if you notice cracks, tears, or dents that seem minor, replacing your mouthguard might be necessary because those little imperfections may end up harboring bacteria.  Another sign that it’s time to replace your mouthguard: you notice staining that you can’t get rid of. For example, you might start to see that the mouthguard is yellowing. Or you might notice the development of dark spots, which might be mold—not just gross, but also a potential health hazard! Here Are the Basic Steps Involved in Cleaning a Mouthguard Do you think that simply rinsing your mouthguard with water after you take it out of your mouth is good enough? Well, the truth is that water alone won’t sufficiently disinfect it. So, what are some steps to follow? 1. Start by using warm water to rinse your mouthguard after you are done using it.  2. Using a bit of mild soap that doesn’t contain alcohol, gently clean every surface of the mouthguard, with or without a soft-bristled toothbrush. Alternatively, you can try a mixture of water and baking soda to clean the mouthguard with a toothbrush. Why not use toothpaste? Well, you can, but you need to be careful about the type of toothpaste you use, as some are too abrasive.  3. On a regular basis, such as once a week, it’s a great idea to soak your mouthguard. You have a few options here as well. For example, you can try putting some mouthwash in a glass of water to create a solution for soaking your mouthguard. As another option, you might soak it in some distilled vinegar, followed by some hydrogen peroxide (allow it to soak for about 30 minutes in each solution, and be sure to rinse the mouthguard thoroughly before putting it in the hydrogen peroxide). Or you can simply use a denture cleaning solution or a cleaner that’s made for mouthguards.  4. After you brush the mouthguard or take it out of whichever cleaning solution you prefer, rinse and dry it with a soft cloth. You can then let it air dry to ensure it’s completely dry before storing it.  5. When you aren’t using it, you can protect your mouthguard, and keep it as sanitary as possible, by placing it in a ventilated case. Just remember that the case should also be cleaned on a consistent basis with soap and water, and the mouthguard should be totally dry before putting it away.   Your Dentist Can Give You Tips on How to Keep Your Mouthguard Clean! Different mouthguards might have different requirements and precautions when it comes to cleaning. Consider talking to your dentist about the steps you should take to keep your particular mouthguard as hygienic as possible. See? It isn’t so hard to clean mouthguards! But if you want to be absolutely sure you’re taking the right approach, talk to your dentist, who can also ensure you get the right type of mouthguard that will be comfortable and effective.  Sources: https://www.colgate.com/en-us/oral-health/dental-emergencies-and-sports-safety/cleaning-a-mouth-guard https://www.smiletownlangley.com/site/blog/2017/12/06/caring-for-cleaning-mouth-guards-langley-children-dentist https://blog.sisuguard.com/how-do-you-clean-a-mouth-guard https://www.sosbraces.com/how-to-clean-your-mouthguard/ https://www.healthline.com/health/how-to-clean-mouthguard#takeaway  

Do you suffer from frequent headaches? Well, the cause of that pain might actually be in your mouth or jaw. It’s true! A lot of people don’t realize that there’s a connection between oral health issues and headaches, but it turns out that the relief you seek might actually be found in your dentist’s chair. Below, we cover what oral health problems might lead to headaches and migraines. With this information, you can then take steps to avoid headaches and keep your mouth healthy. Perhaps the Pain Is Starting in Your Jaw Believe it or not, tension in your jaw might lead to tension in your head. The temporomandibular joint that connects the jaw to the skull might become tense on one or both sides, and that could lead to pain that radiates to your head. If you’re experiencing headaches that you think might be caused by a tense jaw, your dentist can perform a checkup to see if you’re dealing with TMD (temporomandibular joint disorder), also known as TMJ. Then, by getting the right treatment for TMJ, you might be able to get relief from your headaches and migraines as well.  Note: There are several factors that can lead to TMJ, and your dentist can work on figuring out the cause of your discomfort. For example, one potential cause is clenching and grinding the teeth.  Clenching and Grinding Your Teeth Might Lead to Headaches, Too Known as bruxism, clenching your teeth or grinding them might lead to problems with your jaw, and that may result in pain in your head.  Sometimes, people don’t even realize that they’re clenching their teeth throughout the day, particularly during periods of stress. On top of that, clenching and grinding can also occur during the night while you’re asleep. And if that’s the case, you might wake up with a painful headache. There are a few signs that can point to whether or not you’re grinding your teeth or clenching your jaw. For example, you might notice that your teeth are more sensitive than usual, or your teeth look worn or flatter than they should. If your jaw feels tight, sore, or tired, or if you tend to wake up with headaches, those symptoms might also point to bruxism. Rest assured that there are treatment options available. Your dentist might recommend a mouth guard, or you may find relief if you begin incorporating stress relieving techniques into your daily life. It Might Even Be a Problem with Your Bite If your bite isn’t right (known as malocclusion), you might end up with TMJ and headaches. Basically, when your bite is misaligned, your jaw muscles need to work more, and they become increasingly more strained, thereby leading to pain.  So, are you missing a tooth? Or do your teeth fail to line up properly when you close your mouth? Consider talking to your dentist about the treatment options that are available, such as braces for malocclusion and dental implants for missing teeth. That way, you won’t have to keep getting headaches because of your bite. Cavities, Infections, and Headaches There’s a connection between cavities and infections in your mouth and headaches. Who knew?! Put simply, your headache or migraine might be an extension of a toothache, thanks to the trigeminal nerve. Basically, when there’s pain in one area of the nerve, other areas of the nerve might also react, leading to headache. Or, your body might be reacting to a toothache by tightening your jaw—and, as discussed above, that could lead to headaches too.   Brushing and flossing at home, along with professional checkups and cleanings, can help you keep your oral health on track. Plus, when you see your dentist on a regular basis, he or she can spot problems in their earliest stages, before they can lead to other symptoms like headaches. Pro tip: If you’re worried about affording the checkups and treatments you need, don’t worry, as there are affordable dental insurance plans that help cover the cost of everything from cleanings to fillings.    Consider Seeing Your Dentist About Your Headaches Seeing a doctor about your headaches is wise, but if no cause is found, the problem might be originating in your mouth or jaw. At that point, your dentist might be able to pinpoint the cause of your headaches or migraines, as well as give you the treatment that will make the pain go away. Sources: https://www.webmd.com/migraines-headaches/migraine-dental-problems#1 https://healthcare.utah.edu/the-scope/shows.php?shows=0_bt01oaam https://www.deltadentalins.com/oral_health/dental-headaches.html https://drsykes.com/blog/can-cavities-cause-headache-pain/ https://www.humana.com/prevention-and-care/healthy-living-and-prevention/dental-health/tension-headaches https://www.humana.com/dental-insurance/toothache https://www.humana.com/prevention-and-care/healthy-living-and-prevention/dental-health/tension-headaches