And Lady Gaga brought the terrifying image to life on Sunday.
The 27-year-old singer wore the same bizarre grillz in her mouth and a similar hat, while forgoing trousers at the YouTube Music Awards in New York City.
Who's the Little Monster now? Lady Gaga wore terrifying toothy grillz and no trousers at the YouTube Awards in NYC on Sunday
She wore a short black curly wig and sported a milky white complexion.
And in typical outrageous fashion, Gaga wore a leather shirt and no trousers.
She finished off the bizarre ensemble with flashy vertiginous platform boots and socks with a white frill.
Life imitating art: Gaga sported the same scary smile on the cover of her new single Dope
Incognito: She wore a short black curly wig and hat and sported a milky white complexion
Hiding: The Poker Face songstress paired the scary accessory with jet-black round sunglasses
'Tune in now to the YouTube Music Awards! Performing DOPE for the first time,' she wrote.
Gaga played the song at a piano, having taken out her wacky grillz and donned a tartan shirt and baseball cap for the performance.
She removed the glasses to reveal tears on her face as she sang, with rumours recently surfacing that she has split from boyfriend Taylor Kinney.
Feeling confident: The singer appeared to have no qualm walking around without trousers as she made her way backstage
Bizarre: Lady Gaga released the bizarre artwork for her new single Dope on Thursday
The star was joined at New York's Pier 36 by a slew of stars at the first ever YouTube awards bash.
Vanessa Hudgens looked striking in a yellow tinged elaborate floor length gown with sparkling gold heels, while M.I.A. looked typically eye-catching in a loud pink shirt, tie-dye jeans, red pumps and round sunglasses.
Hosted by Jason Schwartzman and Reggie Watts, the event was streamed live worldwide.
Vanessa Hudgens looked striking in a yellow tinged elaborate floor length gown with sparkling gold heels, while M.I.A. looked typically eye-catching in a loud pink shirt, tie-dye jeans, red pumps and round sunglasses.
Hosted by Jason Schwartzman and Reggie Watts, the event was streamed live worldwide.
Internet performance: Gaga played Dope for a live audience at the New York show
Turmoil? Some reports have suggested Gaga has split from boyfriend Taylor Kinney due to her intense workload
My little monsters: Gaga looked overcome as she greeted her fans from the side of the stage
Checkmate: Gaga wore her tooth accessory right up until the last moments before her performance
But Gaga's tearful performance wasn't the first emotional showing in an increasingly bizarre broadcast.
In the show's most awkward moment, hosts Jason Schwartzman and Reggie Watts carried crying babies through the crowd and tried to interview Macklemore and Lewis as they presented them with the Breakthrough award.
Meanwhile, Hudgens and actor Michael Shannon took part in a music video skit which ended up with a 'fan' invading the stage and getting Vanessa in a headlock.
The star ended up sprawled on the floor.
In the show's most awkward moment, hosts Jason Schwartzman and Reggie Watts carried crying babies through the crowd and tried to interview Macklemore and Lewis as they presented them with the Breakthrough award.
Meanwhile, Hudgens and actor Michael Shannon took part in a music video skit which ended up with a 'fan' invading the stage and getting Vanessa in a headlock.
The star ended up sprawled on the floor.
Going for gold: Vanessa Hudgens was elegant in a yellow frock that sported an Eastern design
Look at me: M.I.A. appeared to do a little dance on the red carpet, as she shielded her eyes with yellow-tinted shades
Flashy: Singer M.I.A wore a flashy pink sweater and tie-dye trousers in an eclectic outfit
Famed director Spike Jonze directed live videos with Eminem, Gaga, M.I.A. and rapper Earl Sweatshirt.
Eminem was named artist of the year before performing a word-perfect version of his new lung-busting tour de force Rap God, filmed in black and white.
Actress Gina Gerwig kicked the awards off as the protagonist of a live video of Arcade Fire's Afterlife, directed by Jonze.
Breakthrough: Jason Schwartzman, Ryan Lewis and Macklemore accept their breakthrough award alongside crying babies
Strange baby moment: Schwartzman hosted while holding a very cute baby onstage at the awards
Gerwig
appeared to break up with her boyfriend, then expresses the emotions
she's feeling in an interpretive dance that moved from apartment to
forest to soundstage with a little visual trickery.A short while later Schwartzman and Watts admitted they would be working the 90-minute show without a script - with just notecards standing between them and awkward pauses and brief technical difficulties.
'This is all about anything happening,' Schwartzman said.
Video games: Vanessa Hudgens and Michael Shannon acted out a music video skit for the show
Fun and games: The skit featured a 'fan' getting Vanessa in a headlock and the actress ending up sprawled over the floor
Head over heels: Vanessa looks 'indignant' after ending up sprawled on the floor
Arcade
Fire frontman Win Butler stepped into the shot to take photos with his
iPhone, the show's hosts ran through the crowd a few times, climbed a
ladder, participated in face-painting, performing not one but two
improvised songs.
Earl Sweatshirt and fellow rapper Tyler, the Creator, performed their song Sasquatch in the midst of a mosh pit, using hand-held cameras to relay the frenetic experience while Avicii played the dumb hot guy part in a short film that concluded with a blood-spattered faked double suicide.
And Butler made a return to the stage when he jokingly interrupted as a group of Swift fans accepted her YouTube Phenomenon award for I Knew You Were Trouble.
Earl Sweatshirt and fellow rapper Tyler, the Creator, performed their song Sasquatch in the midst of a mosh pit, using hand-held cameras to relay the frenetic experience while Avicii played the dumb hot guy part in a short film that concluded with a blood-spattered faked double suicide.
And Butler made a return to the stage when he jokingly interrupted as a group of Swift fans accepted her YouTube Phenomenon award for I Knew You Were Trouble.
Big winner: Eminem won the prestigious Artist Of The Year gong and also performed at the show
Artist of the year: Eminem accepted his YouTube gong after an impressive performance
He recreated the infamous moment
when Kanye West rushed the stage during Swift's win at the MTV Video
Music Awards.
'Not Taylor Swift,' Butler said. 'I'm gonna let you finish. Not Taylor Swift. The YouTube phenomenon of the year was definitely the Harlem Shake.
'I don't know. No disrespect, but everybody knows that if you've ever been on YouTube, so whatever.' He then dropped the mic and walked off stage.
'Not Taylor Swift,' Butler said. 'I'm gonna let you finish. Not Taylor Swift. The YouTube phenomenon of the year was definitely the Harlem Shake.
'I don't know. No disrespect, but everybody knows that if you've ever been on YouTube, so whatever.' He then dropped the mic and walked off stage.
Hosts with the most:Reggie Watts and Jason Schwartzman pose backstage with Win Butler of Arcade Fire
Bizarre: Michael Cera emerged on stage to speak to host Schwartzman who looked wore fake blood on his face
Winner: Tiffany of Girls' Generation accepts her going at the bash
According to the Los Angeles Times, 155,000 viewers tuned into watch the beginning of the live stream but soon began to tune out in droves as the unscripted ceremony became more and more bizarre.
During Gaga's performance, more than 4,000 viewers tuned out of the steam amid complaints and there were then complaints about sound quality.
The publication reports that after an hour, the webcast dropped from its peak viewers of 215,000 to around 180,000.
Masculine feminine: YouTube personality Hannah
Hart wore a tie and a waistcoat, while Greta Gerwig was elegant in a
symmetrical black dress
His own party: Rapper T-pain gestured with his hands as she smiled happily for the cameras
The awards - divided into six categories - were voted for entirely by fans.
Girls' Generation - I Got A Boy beat out stiff competition from the likes of Lady Gaga, Miley Cyrus and Demi Lovato to win the Video Of The Year award.
Other winners included DeStorm and Lindsey Stirling and Pentatonix.
Girls' Generation - I Got A Boy beat out stiff competition from the likes of Lady Gaga, Miley Cyrus and Demi Lovato to win the Video Of The Year award.
Other winners included DeStorm and Lindsey Stirling and Pentatonix.
Men of the moment: Ryan Lewis and Macklemore looked suave with their hair gelled as they posed together on the red carpet