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Patient stop brushing their teeth. He will allow me to manually brush, but will hold his mouth open. Afterwards he swallows the toothpaste rather than spit it out.

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I would use the smallest amount possible. Maybe not even use toothpaste. Is there some other natural type of cleaning agent? I really don’t know, just wondering if there is. Maybe call a dentist.

Good luck.
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You can brush adequately with 1/10th the amount of toothpaste you see being used in ads and commercials but even using "normal" amounts the amount of fluoride ingested isn't really that big a concern, especially for someone in the latter part of life.
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In your position, I’d get some professional input regarding making the best of a bunch of less than “good” choices.

So with the idea of finding out-

1.) How toxic is the toothpaste being swallowed?
2.) Is there are toothpaste that is SAFE to swallow that contains relatively benign components?
3.) Is there a recommended alternative to brushing with a brush and paste?
4.) Are the teeth stable enough to benefit from traditional brushing, or is there a potential alternative method?
5.) How dependent on dentition is the nutritional profile of the patient? My LO has lost several teeth in the last year but is actually eating better now than when her teeth were better.

Very kind of you to be oriented to solving problems!!!
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I had the same thought. Try smearing some toothpaste across the brush like you're spreading butter onto something. A very thin, not-much-there layer.

Have a container in hand and put it under his chin so he can spit.
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If possible, try to get a fluoride-free toddler’s training toothpaste. Use such a small amount that swallowing is less of an issue. And finally, use a toothette sponge or swab to wipe off the residue. Good luck!
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