With my Mum I changed to a child size toothbrush which has improved things a bit, the care workers advised me to give up on the swishing and spitting attempts and just make sure she swallows enough liquid to wash down the toothpaste. They no longer use a toothbrush with her, just a tooth sponge wipe but I persevere with brush and paste. I also approach her from the back so the toothbrush is in a natural position in her mouth. I find if I talk to her quietly in her ear while trying to do the deed it goes much easier. Some nights though, she speaks for the only time in the day to say, quite loudly STOP IT!! PLEASE !! THAT'S ENOUGH!! THANKS lol I too would appreciate any other tips.