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I almost gag when he opens his mouth. What must I do?

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Will he brush his own teeth?
Try using a baby tooth brush they are softer than an adult brush.
Also try using a kids or flavored toothpaste, get one with NO fluoride he should not be swallowing fluoride. Non alcohol mouthwash is what I used for my Husband, I stopped using the toothpaste and just used mouthwash. The non alcohol one is less drying.
Some medication can cause dry mouth and that may lead to a sore mouth.
It might be possible that he has a sore mouth. Have you checked for sores, is it possible that it could be thrush or yeast that is the problem?
Is it at all possible to get him to the dentist? Some do make house calls.
If everything in the mouth is alright just try doing it a little at a time maybe after each meal just a few swipes and he may get used to having you do it if he can not or will not himself.
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Someone suggested recently to put a dab of Vicks on your top lip to stop gagging at toilet time. It might also help you cope with the bad breath. And yes, go for mouth wash for him.
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Can you take him to a dentist for professional oral care? He may have tonsil stones, and those can cause a bad odor and would need to be removed by a professional.
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