Introduction: Treatment with intraoral appliances is often used to reduce pain and functional disturbances in patients with TMD. In text-books the resilient appliance/soft splint is a recommended type of intraoral appliance in patients with TMD. It is easy to produce and constitutes a relatively inexpensive treatment. A recently published randomized controlled trial showed no difference in efficacy between the resilient appliance compared to the control appliance in a short-term perspective in patients with TMD-pain. Aim: To investigate the long-term efficacy of the resilient appliance in patients with TMD-pain. Methods: A randomized, controlled trial was performed in 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, non-occluding appliance. Primary treatment outcome measures were judged positive when patients’ TMD-pain at worst (VAS) and CPI decreased by at least 30%. Additional treatment outcomes were frequency of TMD-pain, jaw function/activity and headache the last six months. Results: Patient characteristics did not differ between the groups. There were no statistically significant differences between groups neither regarding frequency of TMD-pain, jaw function/activity and headache the last six months, nor regarding a 30% reduction in pain at worst and CPI. There were however statistically significant differences within the groups regarding reduced pain intensity, frequency and enhanced jaw function between baseline and 12 months follow-up. Conclusion: There was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain, jaw function/activity and headache in a 12 months perspective.