Sweet Tooth, real name Needles Kane is a fictional character from the Twisted Metal video game series. Sweet Tooth is designed around the premise of a killer clown that drives a combat ice cream truck, and his face has been featured on the cover of every Twisted Metal game to date, making him the series mascot. While being in every title of the series he has not always been immediately available, requiring to be unlocked in some. 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.
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). 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.
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. Despite the changes some factors remained uniform, notably the perpetual flame on his head introduced in the second game. Starting with Twisted Metal Black, 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 (which was a re-textured version of the original Sweet Tooth vehicle). 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 is also an unlockable character in War of the Monsters (2003) for the Playstation 2, 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. To unlock it, one must beat the story mode of Twisted Metal: Black with Sweet Tooth and have the save on the memory card. 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.