I haven't seen one of these gifts, but maybe someone can custom make one for your favorite trucker.
A silver toothpick holder, kinda like a pez dispenser, that dispenses a single fresh toothpick, at the flick of a top lid. I would like to hear a click when it opens, like a zippo lighter, and the snap when it closes. That would be nice so you don't have to take your eyes off the road, or say if you needed a fresh one while in the dark or while taking shower maybe.... so also maybe a nice silver chain to hang it from, like dog tags.
Also, don't forget to add a generous supply of red hot cinnamon flavored high quality wood toothpicks... the kind you can chew on for miles.