Despite the unanswered questions on the physiologic mechanisms that explain the effectiveness of intra-oral appliances on reducing symptoms of TMD, there is still a plethora of documentation that intra-oral appliance when used in the management plan accurately, can contribute to the relief of TMD symptoms. The clinician is encouraged to evaluate fully each particular patient case in an effort to develop a differential diagnosis that leads to effective management plan.Before commencing any appliance therapy for a TMD, the clinician should be confident that the patient will benefit from the therapeutic approach. If the symptoms reduced that will provide additional diagnostic information. The clinician also needs to consider that 40% of patients suffering from TMD demonstrate favorable response to therapy from a placebo effect. As with any treatment, a good patient-dentist relationship and concomitant with patent education, can alloy patient feelings and anxieties. It can contributeto a positive and favorable response to intra-oral occlusal splint therapy.