*Marcus "Needles" Kane, better known as Sweet Tooth, is the most famous character and mascot of Twisted Metal. An insane clown who drives a modified ice cream truck, Sweet Tooth's portrayals have varied greatly over the course of the series, with his mental instability, appearance and his vehicle of choice usually being the only real thing each version has in common. Originally simply a psychotic clown for the first two games, his most famous and darkest incarnation saw Needles transform into pure, sadistic evil; He is a brutal serial killer who butchers everyone in his path and is the split personality of Marcus Kane.

Sweet Tooth is extremely twisted and psychotic. he embodies hatred, mayhem, and destruction. He is a complete maniac who takes enjoyment only in spreading death and havoc. Sweet Tooth prides himself on being the greatest serial killer in history, willing to do anything to keep his title. He is also seemingly somewhat of a narcissist and has misogynistic tendencies.

However, his personality seemingly changes depending on what game he's in. Such as in the first game, he's simply just an insane man who enjoys mayhem and wants his paper bag friend back. In Twisted Metal 3 & 4, he is overall sillier and much more of a clown. While in Twisted Metal: Black and the 2012 game, he is a sadistic murderer who enjoys only the pain and suffering of others.*