Darcey uses a battery operated tooth brush that has a spinning head. I put a small amount of tooth paste on it, put it in her mouth, turn it on (as she can no longer do so) and help bring her left hand up to hold it. I then bring her right arm up, resting its elbow on the top of her stomach, so she can hold it from the other side. With two hands she can move it around in her mouth. When she is done, she nods to me... and I'll turn the toothbrush off and pull it out of her mouth. I then put a small plastic cup (double shot glass sized), filled with water, to her lips. She leans her head back slightly and gets whatever amount of water she needs to "swish". When done, she spits back into the plastic cup. I then wash and put everything away. She is beginning to have problems turning the toothbrush over to change from top to bottom teeth. And a few times, I've had to help her with the forward facing sides of her front teeth. I suspect there will come a time, in the not too distant future, when I'll take over that task for her. As difficult as it would be to get her into the dentist's office for a cleaning, we've made it a point to spend some 5 minutes, morning and night, when brushing her teeth. It is our attempt to be wise and proactive...
Jim