Sweet Tooth

Sweet Tooth, real name Needles Kane, is designed around the premise of a killer clown that drives an ice cream truck, and his face has been featured on the cover of every Twisted Metal game to date, making him the series mascot. He is the only character, besides Marcus Kane, to drive more than one vehicle in any of the games, being the driver of Head-On's Dark Tooth, Tower Tooth, and as of Twisted Metal Lost, Gold Tooth. He is voiced by J.S. Gilbert in Twisted Metal: Black.

The character has gone through several redesigns differing from game to game, similar to fellow character Calypso, and his personality has grown progressively darker along the way. Sweet Tooth's original look featured him as a green haired, slim simple circus clown who had escaped from a mental institution. The design was expanded upon in the second game in response to changes to the truck's design, notably due to the clown head adorning the truck now featuring a personality of its own. The result gave Sweet Tooth the flaming head design seen on the character since. 989 Studios which handled the next two games put more emphasis on the clown design, redesigning his attire to that of a ringmaster in Twisted Metal 4; neither design was held in high regard by the developers, with David Jaffe stating his dislike of 3's look. As of Black and beyond, the design was modified heavily, giving him increased bulk and other features that would be called his "classic look" by Incog Inc.'s design team. His design became a large, somewhat overweight bare chested clown with a flaming mask locked into a permanent maniacal smile. Head On expanded on this idea, changing the mask to face paint and the smile to his own.

The ice cream truck was actually designed well before the driver himself, and Black's incarnation took six months and many concept sketches to finalize. Labeled early on "DEMONIC ICE CREAM TRUCK", attention to details such as the head adorning the vehicle and the contents of the back of the truck were focused on during development. Boss variants of the truck have also appeared regularly in the game's series, starting with Dark Tooth in the second game. While the designs for the vehicles have progressed steadily, care has been emphasized to keep them rooted to the simple ice cream truck structure yet unique, something that has become harder and harder for the team as the games go on.

Sweet Tooth has the most ties to any group of characters in the whole series: his father Charlie Kane (driver of Yellow Jacket in the first game) and Marcus Kane (split personality, Roadkill's driver). Spectre's ending in the first game strongly hints that Sweet Tooth was the serial killer who killed the driver of Spectre five years before the competition. In Black, he has an unnamed brother that only appeared in Twisted Metal Black, who himself drove that game's Yellow Jacket vehicle. He is also directly responsible for the creation of that game's Axel, whose wife he killed, and Cage, who wishes to be a greater killer than Sweet Tooth. His mask is also seen in Dollface's middle video, being created by her boss.

Sweet Tooth appears as a car in the child-themed spin-off game Twisted Metal: Small Brawl, based on RC cars instead of real ones. In this game, Sweet Tooth is the youngest and most mischievous kid in the contest, and enters looking for some ice cream. His ending shows that Calypso offers him an ice cream from his familiar Ice Cream truck, but Sweet Tooth instead steals the truck to terrorize Calypso. Sweet Tooth is also an unlockable character in War of the Monsters, a game in which Incognito used the TMB engine to make a movie monster fighting game. One of the characters, Agamo, has Sweet Tooth as the fourth skin. Sweet Tooth is represented by a tall mech with the signature flaming clown head, and often breaks out in his usual laughter throughout the game. Sweet Tooth is also an unlockable character in the North American and European versions of Hot Shots Golf 2. His appearance in this game is closer to his character design in Twisted Metal 3. Sweet Tooth is a DLC character in ModNation Racers with his Ice Cream Kart.