Oral orthopedic appliances are routinely used in TMD management. Oral orthopedic appliances are commonly referred to as occlusal splints, orthotics, night guards, bite guards, or bruxism appliances. These oral orthopedic appliances should be made from hard acrylic, be removable, and cover either all of the upper or lower teeth (the full arch). Oral orthopedic TMD appliances are designed to redistribute occlusal forces, prevent wear, reduce mobility of loosened teeth, reduce or negate the effects of bruxism and/or clenching, reduce jaw muscle pain, and alter structural relationships within the TMJ.

These devices are extremely difficult to fabricate and fit precisely, often requiring repeated visits for adjustments. Many dentists do not have the inclination, skill, or aptitude for fabricating and managing these appliances, and therefore these appliances should not be universally prescribed and utilized. Postgraduate training programs often cannot adequately train residents to fabricate these appliances in order to do reliable research as it relates to the efficacy of these appliances within the timeframe of their programs. Many years of clinical experience are required to competently define the applications of each orthotic design and its fabrication to yield beneficial results.

From a patient's perspective, TMD management or treatment can be time-consuming and an emotionally and physically (and perhaps financially) taxing process. Relief is experienced for some patients after having endured years of un- or misdiagnosed pain. In the worst cases, patients may have been erroneouosly told "the problem is all in your head." Commiting to months of treatment and irregular progress, with occasional minor reversals due to normal physiologic responses, can at times be nearly as draining as the disorder itself. Dentists practicing trained in this area need the temperament to be reassuring, educating, and understanding throughout the process.

All oral orthopedic appliances should be periodically checked and adjusted by an experienced dentist, since harmful changes to the teeth and jaws can occur if appliances are improperly managed. Complications such as dental caries, gingival inflammation, mouth odors, speech difficulties, and tooth movement can occur with incorrect use or design of oral orthopedic appliances.